CPT Codes for Pediatric Orthopaedics

CPT codes are essential for standardizing medical services, billing, and reimbursement, and for ensuring clear communication among providers, insurers, and patients. The purpose of this review is to examine the history of the 33 most frequently reported CPT codes (as recorded by pediatric Orthopaedic fellowships), their shortcomings, and the challenges currently facing the pediatric orthopedist. None of the pediatric Orthopaedic CPT codes have been reviewed since 2007. Many codes lack vignettes that describe the typical work performed by the clinician. Several codes have not been assigned an RVU value in 30 years (and none have been reviewed in the last 17 years). Therefore, it is unknown whether the current wRVU for each of these codes is accurate. The number of designated inpatient visits for many pediatric Orthopaedic codes is likely inaccurate. The Pediatric Orthopaedic Society of North America could take responsibility for overseeing CPT codes used by pediatric Orthopaedic surgeons. This could be done by establishing a committee of experts to review the existing codes and make recommendations regarding code development, revision, or deletion.

(1)There are CPT codes which are unique and important to pediatric orthopaedics.(2)These CPT codes have not recently been reviewed and may be out of date.