Can You Bill an Achilles Tendon Repair With Bone Spur Excision?
Question: A podiatrist performed a calcaneal exostectomy with Achilles tendon repair to remove a bone spur from the patient’s heel. The documentation states the Achilles tendon was healthy at the time of the operation, and the physician had to incise the tendon to reach the calcaneus. The documentation includes information about an extensive repair for the Achilles tendon using the Arthrex SpeedBridge implant system. What procedure codes should I report for the operation? Missouri Subscriber Answer: Use 28119 (Ostectomy, calcaneus; for spur, with or without plantar fascial release) to report the bone spur excision from the patient’s heel. Then, you’ll assign 27650 (Repair, primary, open or percutaneous, ruptured Achilles tendon) for the Achilles tendon repair. Even though the tendon was healthy prior to the procedure, the provider needed to perform an extensive repair, which you stated was noted in the documentation. The detailed documentation should show the extra work put in by the provider to warrant reimbursement for the Achilles tendon repair. Typically, if the tendon is excised to reach the bone spur, then the physician shouldn’t bill for the tendon reattachment as removing the tendon temporarily was needed for the procedure. However, if the tendon is damaged, torn, or ruptured and the surgeon is excising a bone spur, then you should report both codes. Mike Shaughnessy, BA, CPC, Production Editor, AAPC
