Podiatry Coding & Billing Alert

Question: The podiatrist documented an excision for thickening of the Achilles tendon and diagnosed the patient with calcific Achilles tendonitis. Which CPT^®  and ICD-10 codes should I report?

Nevada Subscriber

Answer: The correct ICD-10 code would be M65.27- (Calcific tendonitis, ankle and foot). This code requires a sixth character based upon which foot is affected. You would choose M65.271 for the right ankle and foot and M65.272 for the left ankle and foot. You would go with M65.279 for an unspecified ankle and foot.

Since the calcification qualifies as a lesion, you would choose 27630 (Excision of lesion of tendon sheath or capsule [e.g., cyst or ganglion], leg and/or ankle]) as the CPT^® code.

Medical definition: The Achilles tendon connects the calf muscles to the heel bone — the calcaneus. The Achilles tendon is also referred to as the calcaneal tendon.

Important: Don’t confuse 27630 with 27650 (Repair, primary, open or percutaneous, ruptured Achilles tendon) or 27680 (Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon).

If the podiatrist performs a tenotomy, where he incises the Achilles tendon percutaneously, opt for 27605 (Tenotomy, percutaneous, Achilles tendon [separate procedure]; local anesthesia) or 27606 (… general anesthesia).

A podiatrist normally performs tenotomy to treat tendinitis or to correct clubfoot deformity in children.

If the podiatrist performs tenolysis, which is the release of a single flexor or extensor tendon in the leg and or ankle, use 27680 (Tenolysis, flexor or extensor tendon, leg and or ankle; single, each tendon).

If the patient’s tendon is tight and unable to move freely due to scarring or adhesions, the podiatrist may perform tenolysis to restore function and relieve pain.