Podiatry Coding & Billing Alert

Question: The podiatrist repaired the patient's Achilles tendon with a graft. I'm trying to figure out which code is correct to report for this procedure, but I'm not sure because there are three Achilles tendon repair codes. How do I know which is the right one?
Texas Subscriber

Answer: You will need to check the op notes and the patient's medical record, and then talk with the performing podiatrist to find out more of the encounter's specific details, such as if the repair was primary or secondary.

But, yes, there are three Achilles tendon repair codes, which you'll report as the documentation dictates. Your code choices are as follows:

• 27650 (Repair, primary, open or percutaneous, ruptured Achilles tendon). You will use this repair code when the podiatrist performs a primary open or percutaneous repair on the patient's Achilles tendon without a graft.
• 27652 (Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graft)). You should report repair code when the podiatrist performs a primary repair on a patient's Achilles tendon with the placement of a graft. With 27652, you should not code harvesting the tendon graft separately because that service is included in the code.
• 27654 (Repair, secondary, Achilles tendon, with or without graft). Use this repair code when the provider performs a secondary repair on a patient's Achilles tendon. Use 27654 regardless of whether the provider performs a graft. A secondary repair occurs when the podiatrist performs repair of Achilles tendon for the second time with or without use of graft because the previous one was unsuccessful, or the patient reinjured the tendon. As with 27652, when reporting 27654, if the podiatrist does perform a graft, then you cannot report the harvesting of that graft separately because that service is already included in the code.