# Billing for peroneus tendon repair



## kmartinez (Mar 8, 2019)

I would appreciate any help in regards to the surgery performed, as I have minimal experience in podiatry coding. 

The procedures performed are 
1. Repair of peroneus tendon and groove deepening in the fibula of the peroneal groove, left. 
2. Repair of the superior peroneal retinaculum, left 

The two CPT codes I came up with to cover the procedures are CPT 27658 and 27675. 

Here is the procedure description: 
A curvilinear incision was created over the peroneals from just inferior to the tip of the fibula up approximately 2-3 inches superiorly. Bleeders were clamped and ligated. Sharp and blunt dissection was used to gain access to the superior peroneal retinaculum and to the peroneal tendons. The retinaculum was transected with Metzenbaum scissors. Further incisions exposed the peroneal tendons. The peroneus longus appeared to be in good condition without any flattening or signs of tearing. The broadening was debrided with the Metzenbaum scissors, and the tendon was tubularized and held with a running suture of 2-0 Ethibond. The tendon was torn from approximately 1 inch exposed, and a 1/8th drill bit was inserted behind the peroneal retinaculum, creating space within the fibular canal. The tamp was used to deepen the groove in the fibula. The tendons were placed back in to place, and the peroneal brevis tendon was wrapped with a 4x4 cm EpiFlx placental graft. This was secured with a 3-0 Vicryl. 
Next, the area was flushed with normal saline, and the superior peroneal retinaculum was repaired with 2-0 Ethibond. Ther area was once again flushed with normal saline and closed in layered fashion with 3-0 Vicryl for subcutaneous tissues, and the skin was closed in a subcuticular manner... 

Would the two codes I selected be correct? It seems the 27675 covers the superior peroneal retinaculum repair. Or I may be interpreting that wrong, which is why I would love any help and advice. 

TIA 
KM


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## meghanhannus (Mar 8, 2019)

*Billing for Peroneus Tendon Repair*

Hello kmartinez,

I agree with CPT 27658 for the repair of the superior peroneal retinaculum as it is a flexor tendon. However, I have CPT 27676 for the Repair of peroneus tendon and groove deepening in the fibula. Since the provider includes cutting fibular bone "fibular grooving" _(fibular osteotomy)_ I believe CPT 27676 is the correct code. This is where I am pulling it from the OP report you posted:

"1/8th drill bit was inserted behind the peroneal retinaculum, creating space within the fibular canal. The tamp was used to deepen the groove in the fibula."

So..CPT 27676-LT/CPT 27658-51-LT  

Hope this helps~

M. Hannus, CPC, CPMA, CRC


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## kmartinez (Mar 8, 2019)

Thank you so much M. Hannus for your help. I understand where you got 27676 from and realize how I missed that. 

As I mentioned I rarely bill foot and ankle surgeries for our provider and really appreciate your help. I feel much better now about billing this out. 

K. Martinez CPC


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## meghanhannus (Mar 8, 2019)

kmartinez said:


> Thank you so much M. Hannus for your help. I understand where you got 27676 from and realize how I missed that.
> 
> As I mentioned I rarely bill foot and ankle surgeries for our provider and really appreciate your help. I feel much better now about billing this out.
> 
> K. Martinez CPC



You're welcome! Glad to be of help


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