Podiatry Coding & Billing Alert

Question: The podiatrist performed a repair of the patient’s Achilles tendon for the second time with a graft because the patient had reinjured the tendon. To do this, the podiatrist removed the old sutures and previously placed graft. He debrided the ruptured tendon and removed the scar tissue. The podiatrist utilized a new graft that he harvested from a separate location. He made an incision in another area and carried it down through subcutaneous tissues. He harvested a ribbon of fascia to use for the graft, then he closed the graft site incision with sutures. The podiatrist then incorporated the graft into the Achilles tendon. He controlled any bleeding and closed the soft tissue with sutures. He closed the skin incision. Finally, the podiatrist immobilized the patient’s leg in a short leg cast for at least two weeks. How should I code this procedure?

Iowa Subscriber

Answer: You should report 27654 (Repair, secondary, Achilles tendon, with or without graft). A podiatrist most likely performs a secondary repair for an old tear or a re-tear
of a previous repair with a significant retraction or scarring of the tendon. The podiatrist should note all of this in his documentation. You can report 27654 whether the podiatrist used a graft or not, according to the code’s descriptor.

Don’t miss: You cannot report the harvesting of that graft separately because that service is already included in 27654.