# Achilles Tendon Rupture - indications for surgery



## cjhalk@yahoo.com (Jan 28, 2013)

I am working through the Study Guide for the CSFAC. I guess I have been coding wrong, or I don't understand what they are asking..or something.

In this case, this is the indications for surgery being done that day.

The case study for indications for surgery are as follows:
"The patient reptured his Achilles Tendon when he lost his step off a ladder. After discussing risks, benefits, and alternatives to surgery, he elected to proceed with surgery."

There question is What is theFIRST listed ICD9 diagnosis code for this encounter?


My question is they give four choices for the answer for the diagnosis code.
727.67 - nontraumatic rupture of achilles tendon
727.68 - nontraumatic rupture of tendon of foot and ankle
845.09 - ankle sprain
727.69 - nontraumatic repure of tendon

I answered 727.67 - although I didn't like it because it's clearly traumatic. But certianly WASN'T an ankle sprain. 

So, the answer was Ankle Sprain. 

So my confusion is simply this. As coders we learn you can't assume anything. If it's not in the notes, it didn't happen or isn't there. 

Why in this case is the first ICD9 code listed as Ankle Sprain when the Indications for surgery don't mention that the patient sprained his ankle. Jus tmentions that he lost his tep off a ladder.

The rational for the answer is not helpful. "This note describes an Achilles injury. In ICD9 Rupture/tendon/Achilles is indexed to 845.09."

So does this mean that 845.09 isn't related only to a sprain but can be listed as the Rupture of the achilles tendon? ICD9 Book has 845 listed as Sprains and Strains of Ankle and Foot. .09 is "Other" but list "Archilles Tendon." My problem with that is this is a rupture, not a sprain or strain. 

What am I missing or looking to deep?

Thank you for any help.


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## dclark7 (Jan 29, 2013)

Look at the "includes" list at the beginning of the 840 section in your ICD book, you'll find your answer there.  I could tell you, but if you're like me you learn better by looking for yourself.


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## cjhalk@yahoo.com (Jan 29, 2013)

oh..wow..check that out. I really should have looked there. 

thank you very much, and thank you very much for not just telling me the answer. 

perfect!!


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