Reader Questions:
Pick Apart 'Primary' vs. 'Secondary'
Published on Mon Apr 21, 2008
Question: For codes such as 27695, 27696 and 27698, what do the terms "primary" and "secondary" mean? Does secondary mean the patient had a previous surgery for the tear, or does it refer to a surgical method? Louisiana Subscriber Answer: The answer is that "secondary" relates to both a subsequent surgery and surgical method. Note these code descriptors: - 27695 -- Repair, primary, disrupted ligament, ankle;collateral - 27696 -- - both collateral ligaments - 27698 -- Repair, secondary, disrupted ligament, ankle, collateral (e.g., Watson-Jones procedure). Primary: In these codes, "primary" refers to the rare direct repair of an acute ligament injury or severe ankle sprain. Secondary: "Secondary" refers to repair of chronic ligamentous problems, such as for an athlete with frequent and recurrent ankle sprains. For secondary repairs, keep an eye out for the following key words: - Brostrom procedure - Watson-Jones procedure - Crisman-Snook procedure. Both the Watson-Jones and Crisman-Snook procedures involve harvesting a local tendon, usually a portion of one of the peroneal tendons. If your surgeon's operative note mentions harvesting a personal tendon, it is almost certainly a secondary repair, or 27698.
