Wiki Proximal Hamstring Repair

[adunlap23]

It seems the AMA no longer recommends using an unlisted code for proximal hamstring repair. From what I understand, they are now advising coders to report this procedure with 27385.

I do not have access to CPT Assistant, so I can’t verify this myself. Can anyone confirm this is correct or share the CPT Assistant article where this update is published?

 

[hnfbernard@gmail.com]

You are correct - Coding Correction: Reporting Open Repair of Proximal Hamstring Tendon (27385)(May 2025 / Volume 35 Issue 5)

 

[NRaizman]

Proximal HamstringTendon (27385)​

May 2025 page 32​

Coding Correction: Reporting Open Repair of Proximal HamstringTendon (27385)
This coding correction is intended to address an error in coding guidance specific to the appropriate code to report an open proximal hamstringtendon repair. The answer in the FAQ: Musculoskeletal System in the January 2015 issue of CPT® Assistant incorrectly advises that “t would be appropriate to report code 27599, Unlisted procedure, femur or knee, to repair an open hamstring tendon.”
However, the relevant specialty society advises that it would not be appropriate to report unlisted code 27599 for an open repair of a proximal hamstring tendon. Instead, it would be appropriate to report code 27385, Suture of quadriceps or hamstringmuscle rupture; primary, for an open repair of a proximal hamstring tendon. Note that the open tenotomy hamstring codes are located in the Femur (Thigh Region) and Knee Joint subsection, which states “ncluding tibial plateaus” (ie, from knee to ankle). Therefore, the advice in this coding correction supersedes the advice given in 2015.

 

[adunlap23]

Proximal HamstringTendon (27385)​

May 2025 page 32​

Coding Correction: Reporting Open Repair of Proximal HamstringTendon (27385)
This coding correction is intended to address an error in coding guidance specific to the appropriate code to report an open proximal hamstringtendon repair. The answer in the FAQ: Musculoskeletal System in the January 2015 issue of CPT® Assistant incorrectly advises that “t would be appropriate to report code 27599, Unlisted procedure, femur or knee, to repair an open hamstring tendon.”
However, the relevant specialty society advises that it would not be appropriate to report unlisted code 27599 for an open repair of a proximal hamstring tendon. Instead, it would be appropriate to report code 27385, Suture of quadriceps or hamstringmuscle rupture; primary, for an open repair of a proximal hamstring tendon. Note that the open tenotomy hamstring codes are located in the Femur (Thigh Region) and Knee Joint subsection, which states “ncluding tibial plateaus” (ie, from knee to ankle). Therefore, the advice in this coding correction supersedes the advice given in 2015.

Perfect. Thank you!