# Achilles Tendon Assistance Please.....



## caromissunc1 (Nov 26, 2012)

The doctor performed an "Achilles tendon debridement, treatment with Topaz microdermabrader, and injection of platelet rich plasma."
I can find the PRP code as 0232T, (which MCR won't pay), but I am having an awful time finding a CPT code for this procedure.  The doc wants to use 27654, but the tendon is not being repaired from a rupture.  I looked at code 27680, but I don't think that really fits either.  
The DX is tendinosis.  Should I report 726.71 Achilles tendonitis, or 726.8, other enthesopathies?
HELP!


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## BCrandall (Nov 27, 2012)

I treat tendinosis as tendinitis so 726.71 is what I would use. Is it possible to post the Op Note? When my guys debride one they usually have to suture it...

-Bruce


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## caromissunc1 (Nov 29, 2012)

*Achilles Tendon Assistance Part II*

Dx-  Achilles Tendinosis; failed previous nonoperative procedures
Proc.- Achilles Tendon Debridement, Treatment w/ microdermabrader, and PRP Injection

Description-  Using a 15 blade scalpel, incision was made over the fusiform area of swelling to the Achilles tendon.  The tendon was split and the tendinosis was ellipsed from the normal tissue.  A Topaz microdebrider was then used to encourage vascularity of the remaining tissue.  Debridement was carried out in the substance of the tendon, as well as the periphery.  Copious irrigation was carried out and the tendon was reapproximated with a 3-0 Monocryl.  The tendon was then injected with autologous platelet rich plasma to again encourage healing of the tendinosis.  Skin was subsequently closed and dressings applied.

What ICD-9 and CPT should I use?

Thanks for the help!


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## BCrandall (Nov 30, 2012)

727.67 for the ICD code. Look at 27650 and think about how the "tendinosis" ruptured the normal tendon tissue and had to be excised. It sounds like the "tendinosis" your doc mentions is really a tear in the Achilles Tendon. You might want to query the doctor for confirmation, I do that a lot!


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