Wiki Peroneal Tenodesis

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adunlap23

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The doctor performed a side-by-side tenodesis of the peroneal longus and peroneal brevis tendons. What cpt code best matches this procedure?
 
What did you think the CPT was? What did you come up with in trying to look it up? What was the diagnosis? Was anything else performed at the same time?
 
The surgeon performed a modified Brostrom ankle stabilization on the patient, along with peroneal tenosynovectomy and side-by-side peroneal tenodesis. The op report states that the patient has ankle instability, peroneal tendon tear and peroneal tenosynovitis.
My research indicates that a side-by-side tenodesis is actually considered a tendon transfer, but the only code that I have found to come close to a tendon transfer of the foot/ankle is 27691. However, 27691 seems to be much more extensive than the side-by-side transfer. I have thought of using 27658 for repair of the flexor tendon, since the doctor is repairing the peroneal longus tendon by surturing it to the peroneal brevis tendon, but I'm not sure this is appropriate.
There are a lot of articles on the peroneal side-by-side transfer, so it seems like a common procedure. I just can't find much information on how to code it. I was hoping someone on here has experience with payers and what they will accept for this type of procedure.
Any help would be much appreciated!
 
I think there is a CPT Assistant about this, I just can't log into it right now: https://www.findacode.com/newsletters/ama-cpt-assistant/faq-erratum-qa-february-2016-2.html
Depending on where the work was done either at the foot level or ankle level it can vary. It's always a toss up between 28200, 27658, or 27659. I am not sure without seeing the entire op report description if 27691 would be appropriate for this.
There is also a note in Encoder that says "Report 27690 for peroneal tendon transfers on the same side of the foot."
Brostrum is definitely 27698.
 
amyjph said:
I think there is a CPT Assistant about this, I just can't log into it right now: https://www.findacode.com/newsletters/ama-cpt-assistant/faq-erratum-qa-february-2016-2.html
Depending on where the work was done either at the foot level or ankle level it can vary. It's always a toss up between 28200, 27658, or 27659. I am not sure without seeing the entire op report description if 27691 would be appropriate for this.
There is also a note in Encoder that says "Report 27690 for peroneal tendon transfers on the same side of the foot."
Brostrum is definitely 27698.
Click to expand...
Thank you for your help. I don't access to CPT Assistant. What is Encounter? I've never heard of it.
 
It's an Optum coding product: https://www.optumcoding.com/online-coding/online-medical-coding-software/

I checked CPT Assistant, FAQ May 2021/Volume 31/Issue 5 Question asked: Should code 27690 or 27691 be reported if a physician performed a transfer of the peroneus brevis tendon to the peroneus longus tendon? Answer states, "Peroneal tendon transfers to the same side of the foot should be reported as a superficial tendon transfer; therefore, report code 27690..."

You wouldn't use 27691 unless it was rerouted to the other side or deeper (my opinion).
 
Thank you so much! I have been researching this all weekend, but I don't seem to have the right resources. I think I need to talk to my employer about investing in CPT Assistant. I really appreciate you taking time to help me figure this out.
Have a wonderful day!
 
adunlap23 said:
Thank you so much! I have been researching this all weekend, but I don't seem to have the right resources. I think I need to talk to my employer about investing in CPT Assistant. I really appreciate you taking time to help me figure this out.
Have a wonderful day!
Click to expand...
You're welcome. Yes, it's pretty necessary for situations just like this. This exact same question plagued me when I first started doing foot & ankle years ago.
 
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