# primary vs secondary Achilles tendon repair



## NEOSM507 (Feb 20, 2020)

Can someone clarify the difference between a primary and secondary achilles repair (27652 vs 27654)?

Supercoder says that a secondary repair, 27654 is when "The provider performs repair of Achilles tendon for the second time with or without use of graft because the previous one was unsuccessful or the patient re-injured the tendon."
But I read elsewhere that a primary repair is when the injury is acute, and a secondary is when the condition is chronic.

Thank you


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## haraml7 (Feb 21, 2020)

Both of these sources seems correct. The primary is first acute repair. The secondary is when the patient comes in again or had previous surgery but is still having issues (chronic) and needs a secondary repair. 
Is this the first time your doc is seeing the patient? If so did the patient have a repair done previously? whether done by your doc or another?


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## shecodes (Feb 27, 2020)

CDR shows that 27654 the physician repairs a secondarily torn tendon. 

The repair would be secondary to an underlying condition that caused the tear such as a calcaneal spur or "pump bump" as shown in Coding Clinic for HCPCS 3rd quarter 2010.


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