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Calcaneal exostectomy with achilles repair

Y

yvetteprater

Contributor
Messages
23
Location
Imperial, MO
I have researched billing these two procedures together. I am getting confused when you can bill the achilles repair. Physician did incise the tendon to get to the calcaneous, but there is extensive detail in the repair documentation. He used the arthrex speed bridge system. Can you bill 28118 and 27650 together?
 
Great question! Its the proverbial chicken or egg scenario...which came first? If the tendon is excised to reach a spur, then reattaching the tendon would not be billable in my opinion. However, if both things exist, a torn, damaged, ruptured tendon AND a spur and a repair and ostectomy are both performed, then, yes, both can be coded. Interestingly, there are no coding pairs for 27650 and 28118, so some are comfortable coding both in either scenario.
 
Podcoder70, I'm looking for guidance to justify billing 28118 and 27659-XS together. Our surgeon documents debriding fibrotic tissue of the Achilles tendon in his note before reattaching the Achilles tendon. 27659 then becomes primary since it allows more RVUs than 28118. Our surgeon is adamant, we just can't find anything to support but this thread is close. Do you have anything that shows that this is appropriate?
 
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