Wiki Achilles Tendon Code

[wstuckey]

I have a coding question in which I need an independent opinion. This is the information on the procedure:

The achilles tendon rupture ends were freshened up with a 15 scalpel blade. A #5 fiber-wire was woven in a running locking fashion proximally and distally. The Achilles tendon was held opposed and the tendon was tied on both sides with a #5 fiber-wire achieving excellent opposition of the Achilles tendon rupture ends with no gapping with ankle dosiflexion. However because of the shredding at the Achilles tendon repair site it was felt that graft jacket supplimentaion was necessary. At this point the graft jacket was allowed to rehydrate for ten minutes then a 4X7 Max force graft jacket was then sutured into place. It was sutured into place after cutting it so that it would laid over the Achilles tendon. ……………………………………………….

I coded this as 27652. I was told that this is incorrect. That the procedure should be billing out as 27650 and 27899 (unlisted for the graft).

 

[Lliza71]

Achilles tendon code

Hi,
I'm w/Foot/Ankle ortho surgery. We do a lot of these. If I were coding this, I would use the 27650. The 27652 includes obtaining graft, but where did your doc get the graft from? Was it from the pt himself, or did he order through a vendor?
The 27652 would mean that the dr would repair the tendon, and obtain the graft from the pt himself through a separate incision.
I'm not sure why you were told to use the unlisted code though. If you're getting the graft from a vendor, you cannot bill for the graft itself. I understand you want to bill for the dr's time required to place the graft. We never get pd on any unlisted codes here. We don't even use them. But I guess you could try and see what happens.
Hope this helps,
Liza