Wiki 27479

[lorebe22]

My surgeon did epiphyseal arrest of distal femur and proximal tibia but does not mention fibula and wants to use 27479. I see this scenario alot in Ortho - not sure why there is no such code written yet.
I also saw this same question posted in 6/2009 with No replies so I'm really hoping to at least get an opinion out there!! Thanks!!

 

[kimmcelderry@gmail.com]

I'm bumping this question because I would love an answer. Epiphysiodesis of Distal femur and proximal tib only. Any advice?

 

[deebizness]

I'm bumping this question because I would love an answer. Epiphysiodesis of Distal femur and proximal tib only. Any advice?

I am of the opinion that CPT code 27479 is correct. The key word here is combined (a combination code).
Combination - a joining or merging of different parts or qualities in which the component elements are individually distinct.

It seems to me, that using any combination of Femur + Tib/Fib would satisfy this CPT code. There is a solid chance that I am wrong, but this is how I am interpreting the wording of the code set. Normally the codes set would look like this:

27475 Arrest, epiphyseal, any method (e.g., epiphysiodesis); distal femur
27477 Arrest, epiphyseal, any method (e.g., epiphysiodesis); tibia and fibula, proximal
27479 Arrest, epiphyseal, any method (e.g., epiphysiodesis); distal femur, proximal tibia and fibula

In reality 27479 says:

27479 Arrest, epiphyseal, any method (e.g., epiphysiodesis); COMBINED distal femur, proximal tibia and fibula

Adding the word combined to 27479 leads me to believe that any combination (aspects) of those two codes 27475 and 27477, makes 27479 the correct code. I suppose you could always add a reduced services modifier, but I would not....based on the language.

 

[kimmcelderry@gmail.com]

I am of the opinion that CPT code 27479 is correct. The key word here is combined (a combination code).
Combination - a joining or merging of different parts or qualities in which the component elements are individually distinct.

It seems to me, that using any combination of Femur + Tib/Fib would satisfy this CPT code. There is a solid chance that I am wrong, but this is how I am interpreting the wording of the code set. Normally the codes set would look like this:

27475 Arrest, epiphyseal, any method (e.g., epiphysiodesis); distal femur
27477 Arrest, epiphyseal, any method (e.g., epiphysiodesis); tibia and fibula, proximal
27479 Arrest, epiphyseal, any method (e.g., epiphysiodesis); distal femur, proximal tibia and fibula

In reality 27479 says:

27479 Arrest, epiphyseal, any method (e.g., epiphysiodesis); COMBINED distal femur, proximal tibia and fibula

Adding the word combined to 27479 leads me to believe that any combination (aspects) of those two codes 27475 and 27477, makes 27479 the correct code. I suppose you could always add a reduced services modifier, but I would not....based on the language.

Thank you. It's confusing because 27485 states "Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula" so why doesn't it state "or" for 27479? I wonder if the full epiphyseal arrest always includes both?