iowagirl77
Expert
I'm having difficulty in choosing the right combination of codes for these procedures. I believe the haglund excision is 28120. I don't believe the Achilles debridement is separately billable. For the Achilles lengthening I'm looking at 27685 or 27687, but neither one seems an exact fit.
Procedures: Left Achilles tendon debridement with Haglund excision and Achilles tendon lengthening.
An approximately 10 cm incision was made over the posterior aspect of the heel and was taken down through skin and soft tissue. The tendon was split down the midline, and all degenerative and teninotic debris was excised. We then elevated the tendon from its calcaneal insertion, then used an osteotome and rongeur to removed the prominent haglund deformity and associated bone spurs. We then irrigated the area and tightly reattached the healthy tendon down to the calcaneus using the Arthrex SpeedBridge. We then made a 3 cm incision over the mid posterior calf, protecting the sural nerve and lesser saphenous vein, and made a medial to lateral incision across the gastrocnemius fascia allowing us to lengthen the Achilles approx. 10 degrees. The areas were all then irrigated and closed in layer fashion.
Susan Reinier, CPC
Procedures: Left Achilles tendon debridement with Haglund excision and Achilles tendon lengthening.
An approximately 10 cm incision was made over the posterior aspect of the heel and was taken down through skin and soft tissue. The tendon was split down the midline, and all degenerative and teninotic debris was excised. We then elevated the tendon from its calcaneal insertion, then used an osteotome and rongeur to removed the prominent haglund deformity and associated bone spurs. We then irrigated the area and tightly reattached the healthy tendon down to the calcaneus using the Arthrex SpeedBridge. We then made a 3 cm incision over the mid posterior calf, protecting the sural nerve and lesser saphenous vein, and made a medial to lateral incision across the gastrocnemius fascia allowing us to lengthen the Achilles approx. 10 degrees. The areas were all then irrigated and closed in layer fashion.
Susan Reinier, CPC