Revenue Cycle Insider

Question: I am new to podiatry coding and need help reporting this procedure. The surgeon released the EDL tendon at the midfoot and anchored the tendon into the lateral cuneiform. A wire was placed in the cuneiform and drilled with 5.5 reamer to 20 mm. The surgeon then placed the tendon into the hole and pulled with fiber-wire to the physiological tension and length.

What codes would you recommend for the procedure? What is the EDL tendon?

Nebraska Subscriber

Answer: Assign 27691 (Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)) for the tendon transfer procedure. The difference between 27691 and 27690 (… superficial (eg, anterior tibial extensors into midfoot)) is that 27691 involves a tendon that is deeper within the body structure, while 27690 is designated for a procedure that takes place closer to the surface of the skin.

An extensor digitorum longus (EDL) tendon is attached to the EDL muscle and splits into four sections that connect to the second and third phalanges of the four smaller toes. 

Mike Shaughnessy, BA, CPC, Development Editor, AAPC