Orthopedic Coding Alert

Answer: If that is the extent of the procedure, then you would report 27880 (Amputation, leg, through tibia and fibula) with modifier LT (Left side) or RT (Right side) appended to indicate laterality.

During a 27880 amputation, the surgeon amputates the leg below the knee, through the bones in the lower leg, to relieve pain and/or remove nonhealing tissue in the presence of poor vascular supply. The surgeon then closes the remaining skin flaps around the amputation site.

When there is another component to the procedure, however, your coding will likely change. Here’s a list of the other amputation codes you might use in this scenario:

• 27881 (… with immediate fitting technique including application of first cast)

During this surgery, the surgeon performs the same type of amputation as described in 27880. After closing the remaining skin flaps around the amputation site, however, they apply a cast in a manner that permits immediate fitting of a prosthesis.

• 27882 (… open, circular (guillotine))

During this surgery, the provider amputates the patient’s leg below the knee without leaving a skin flap. This type of amputation is employed when rapid amputation is necessary to stop complications such as rapidly ascending necrosis, tissue death, or hemodynamic compromise.

• 27884 (… secondary closure or scar revision)

During this surgery, the surgeon closes a surgical wound left open at a prior below-knee amputation. You’d also use 27884 when the surgeon revises the stump scar to permit the use of an artificial leg.

• 27886 (… re-amputation)

During this surgery, the surgeon re-amputates the leg below the knee, through the bones in the lower leg, because of nonhealing of the original stump and/or persistent infection.