Podiatry Coding & Billing Alert

Question: Our podiatrist excised a portion of our patient's Achilles tendon, reanastomosed the tendon using running sutures, and then used the Topaz procedure to augment the repair. The patient's tendon wasn't torn or ruptured. Is 27650 the correct code for this treatment?

California Subscriber

Answer: No, 27650 (Repair, primary, open or percutaneous, ruptured Achilles tendon) is not appropriate in your particular case. Depending on which best describes the kind of procedure your podiatrist performed, you should select one of the following codes:

• 27605 -- Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia

• 27606 -- ... general anesthesia

• 27654 -- Repair, secondary, Achilles tendon, with or without graft.

Here's why: If you look at the code descriptor for 27650, it specifies that this code is for the treatment of a ruptured Achilles tendon. So it is not appropriate for you to report this code when the patient did not have a torn or ruptured tendon.

On the other hand, 27605, 27606, and 27654 apply to treatment of conditions that may not involve a ruptured Achilles tendon, such as excision of degenerated tendons.