Wiki Fixation of superior retinaculum of peroneal tendons of foot/ankle to distal fibula

[nsteinhauser]

Hello,
I searched in the archives here and couldn't find any posts that addressed this.
Surgeon repaired (suturing together) split tear of peroneal brevis. In order to gain access, had to open the superior retinaculum. In closing, ended up reapproximating the retinaculum to the distal fibula with Q-fix anchor.
Dx was peroneal brevis tear and ankle instability.
I'm using 28200 for sewing together the peroneal brevis.
Does that 28200 also cover repair of retinaculum? Or, since the retinaculum was repaired not by just sewing it together but by by transfering it and fixing it to the distal fibula, would that warrant an additional code of 27690?
If yes, is the ankle instability a valid diagnosis to cover fixing the retinaculum to somewhere else?
Thank you in advance for any and all ideas.

 

[amyjph]

I would not see this as separately reportable. Closure of the wound and repair of tissues divided for exposure, incision to expose the tendon, retrieval of the tendon and repair of the sheath are included. Due to the wording, "in order to gain access, had to open the superior retinaculum."

 

[nsteinhauser]

The wording was mine - but there was no other reason given for opening up the retinaculum other than "to gain access" - see below.
"I opened the peroneal tendon sheath inferior to the fibula with tenotomies. The 2 peroneal tendons were found. The peroneal brevis had a split tear posterior to the fibula and going up through the superior peroneal retinaculum. Therefore, I did open the superior peroneal retinaculum to gain access to the tear. The 2 tendons were identified. There was thick tenosynovitis around the tendons as well as tenosynovitis had a brown discoloration consistent with hemosiderin deposit. The split tear was repaired with a running 3-0 Ti-Cron suture. The tendons were debrided slightly to fit better behind the fibula. I then drilled and impacted a Smith & Nephew Q-Fix anchor into the posterior aspect of the fibula. I used the #2 Ultrabraid suture from the anchor and reapproximated the superior retinaculum to the distal fibula."

The computer-assisted coding program listed it but I always thought the same, that if there wasn't a separate diagnosis for repairing and/or reapproximating the retinaculum, it would be included in the repair of the peroneal tendon.
Thank you for your response.