Podiatry Coding & Billing Alert

Question: My podiatrist performed an Achilles rupture repair. Which CPT^® code should I report for this procedure?

North Carolina Subscriber

Answer: You haven’t provided enough information to select the correct CPT^® code. Go back to the documentation and look for details such as whether this was a primary or secondary repair. You must also see if your podiatrist used a graft or not.

You have the following codes to choose from for Achilles rupture repair:

• 27650 (Repair, primary, open or percutaneous, ruptured Achilles tendon) and 27652 (… with graft (includes obtaining graft))
• 27654 (Repair, secondary, Achilles tendon, with or without graft)

Code 27650: You should report 27650 for an acute, primary Achilles tear that your podiatrist repairs without a graft.

Code 27652: You should report 27652 for an acute, primary Achilles tear that your podiatrist uses a graft to repair.

Code 27654: You should report 27654 for secondary repairs and delayed repairs. For example, if a primary repair failed or the patient experienced a re-tear, code 27654 would be appropriate.

Code 27654 could also be used for repair of a chronic tear where scar tissue and adhesions have formed. This sometimes will alter anatomy and make repairs more difficult. Per CPT^® Assistant, code 27654 may also be reported for “debulking” of a diseased Achilles tendon.