Summary & Overview
CPT 27257: Closed Treatment of Developmental Hip Dislocation
CPT code 27257 represents a closed reduction procedure for spontaneous developmental hip dislocation, including congenital or pathological dislocations, performed under anesthesia with manipulation, traction, or abduction and splinting. This code is used to bill for the surgical maneuver to realign a dislocated hip without open surgery. Nationally, accurate use of this code matters for surgical coding consistency, quality measurement, and appropriate reimbursement for orthopedic and pediatric procedures.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when the procedure is performed, the typical sites of service, and the kinds of documentation elements expected for coding and billing. The publication also outlines common modifiers encountered with this service and highlights related policy and coverage themes that influence claims processing and medical necessity review. The content is intended to inform coding professionals, revenue cycle teams, and policy analysts about the clinical nature of the service, payer coverage landscape, and areas where documentation and coding precision affect claim outcomes.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 27257 describes a closed treatment of a spontaneous developmental hip dislocation, including congenital or pathological hip joint dislocation. The procedure involves realigning the dislocated hip by manipulation, traction, or application of abduction and splinting while the patient is under anesthesia.
Service type: Closed reduction and manipulation of a hip dislocation
Typical site of service: Operating room or procedure suite with anesthesia support; post-procedure immobilization and follow-up care may occur in an inpatient or outpatient orthopedic setting.
Clinical & Coding Specifications
Clinical Context
A 3-week-old female infant presents to the pediatric orthopedic clinic after newborn screening and physical exam raised concern for a unilateral hip instability. On exam there is limited abduction of the left hip and a positive Ortolani maneuver. Ultrasound confirms a reducible developmental dysplasia of the hip (DDH) without acetabular fracture. The care team discusses closed reduction under general anesthesia with possible spica casting.
The clinical workflow: preoperative evaluation by pediatric orthopedics, informed consent, anesthesia assessment, operative closed reduction of the hip with manipulation under anesthesia using abduction and placement of a hip spica or immobilization device, intraoperative fluoroscopic confirmation of reduction, application of spica cast in the operating room, recovery from anesthesia, and postoperative follow-up with imaging and cast care instructions. Typical perioperative documentation includes indication, consent, anesthesia type, manipulative technique, use of fluoroscopy, laterality, casts/splints applied, and postoperative plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the closed treatment is performed on the right hip |
LT |