Wiki Primary peroneus brevis tendon repair?

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Primary peroneus brevis tendon repair?

For this tendon repair, you can use CPT® 27658 Repair, flexor tendon, leg; primary, without graft, each tendon or 27659 Repair, flexor tendon, leg; secondary. But after reading your op report, it looks like the approach is by ankle:

MRI shows longitudinal tearing of peroneus brevis tendon, attention was directed to the area just posterior to the lateral malleolus of the left ankle, where an approx. 8cm long hockey stick shaped incision as created. the incision was deepened within the same plane taking care to avoid all neurovascular structures. The incision was then deepened down to the level of the peroneus longus tendon, which is noted to be pristine. The longus tendon was reflected laterally and exposing the preoneus brevis tendon which was found to have a large complete intrasubstance tear from the malleolus down to the styloid process with 0 vicryl, the torn tendon was primarily repaired.
Because the approach is by ankle, the better code choice is 28200 Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon.

BFAITHFUL

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What cpt can I use for this procedure? Patient has torn peroneus brevis tendon of ankle.
 

BFAITHFUL

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Wait... I just wanted to make sure you guys saw the actual op note, because it looks like their approach is by the ankle .


MRI shows ongitudinal tearing of peroneus brevis tendon, attention was directed to the area just posterior to the lateral malleolus of the left ankle, where an approx. 8cm long hockey stick shaped incisionw as created. the incision was deepened within the same plane taking care to avoid all neurovascular structures. The incision was then deepened down to the level of the peroneus longus tendon, which is noted to be pristine. the longus tendon was reflected laterally and exposing the preoneus brevis tendon which was found to have a large complete intrasubstance tear from the malleolus down to the styloid process with 0 vicryl, the torn tendon was primarily repaired.
 

BFAITHFUL

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CPT 28200 is a procedure of the foot, but the peroneous brevis tendon starts at the leg and goes down to the foot, and according to op note above, it looks more like the surgery was of the leg/ankle not foot, "incision made at the posterior of the lateral malleolus"


Definition: The lateral malleolus is a bony prominence on the fibula, one of the long bones which makes up the lower leg
 

jdemar

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I do understand the anatomy of the leg/ankle. My 2nd respone is according the 'Orthopedic Decisions' (12/03/10 Pink Sheet Vol.11, No. 12) a service of DecisionHealth, per Margie Vaught.
Question-Are the peroneal brevis/longus tendons considered flexors or extensors? If surgeon is doing repair of such, should report be 28200, 28202, or 28210 for foot or 27658, 27659, 27664 or 27665 for ankle repair? There is no dislocation to support 27675 or 27676.

Answer-peroneals are considered "flexors" or evertors, the AMA recently confimed to her, after consulting with a CPT advisor from the American Orthopaedic Foot and Ankle Society.
Of the peroneal tendons, only the peroneus tertius tendon has "extensor" capability.

Some orthopedic coders might be tempted to report repair of the peroneal tend. with ankle codes, but the AMA confirmed that code 28200 would be the appropriate code to report for repair of the peroneals when no subluxation or dislocation is present.(once per tendon.) 28200 twice with -51 modifier to 2nd code.
 
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Peroneal tendon repair code

I do understand the anatomy of the leg/ankle. My 2nd respone is according the 'Orthopedic Decisions' (12/03/10 Pink Sheet Vol.11, No. 12) a service of DecisionHealth, per Margie Vaught.
Question-Are the peroneal brevis/longus tendons considered flexors or extensors? If surgeon is doing repair of such, should report be 28200, 28202, or 28210 for foot or 27658, 27659, 27664 or 27665 for ankle repair? There is no dislocation to support 27675 or 27676.

Answer-peroneals are considered "flexors" or evertors, the AMA recently confimed to her, after consulting with a CPT advisor from the American Orthopaedic Foot and Ankle Society.
Of the peroneal tendons, only the peroneus tertius tendon has "extensor" capability.

Some orthopedic coders might be tempted to report repair of the peroneal tend. with ankle codes, but the AMA confirmed that code 28200 would be the appropriate code to report for repair of the peroneals when no subluxation or dislocation is present.(once per tendon.) 28200 twice with -51 modifier to 2nd code.







Hi thanks for the valuable inputs about peroneus brevis tendon repair.......where can i get the articles regarding the AMA confirmation about 28200 code for this scenario..It would be helpful for my audit quotes.
 
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