Orthopedic Coding Alert

Question: Please provide the ICD-9 and CPT codes for the following:
Diagnosis:
1. Nonunion of medial talar fragment.
2. Posterior tibial tendon dysfunction.
Procedure:
1. Transfer of FDL to posterior tibial tendon.
2. Excision of posteromedial talar fragment.

New Mexico Subscriber

Answer: For the transfer of FDL to posterior tibial tendon, you report code 27691(Transfer or transplant of single tendon [with muscle redirection or rerouting]; deep [e.g., anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot]). The diagnosis code 726.72 (Tibialis tendinitis) is for the possible tendinitis causing the dysfunction. Your surgeon is excising the talar fragment to repair the nonunion. You report this with code

28320 (Repair, nonunion or malunion; tarsal bones). The diagnosis code for the nonunion is 733.82 (Nonunion of fracture).