coding update Tendon Repair Coding: Primary Versus Secondary Repair By Jonathan Huey, DPM, and Michael King, DPM Some confusion continues to exist about what constitutes a primary tendon repair versus a secondary repair. CPT literature relates the following directions when determining the correct code for reimbursement: Primary repair: Any repair of an acute injury completed within the first 24 hours after the injury. Delayed primary repair: A repair performed within 24 hours to two weeks of the injury. Secondary repair: A repair performed after two weeks of injury. APMA has provided additional guidance to members in past coding education on this subject1 indicating that primary repairs usually involve direct 38 apmanews MARCH/APRIL 2024 , surgical correction of the injury, while secondary repairs may include tendon grafts or other more complex procedures. Below are the most common types of tendon repair code options for the ankle and lower leg. The key element is the time frame of the surgical approach and then what is done, using the most exact code possible. Should no code exist, using the unlisted surgical code (CPT 27999) is an option. The unlisted code requires a manual review by the payer but is often the best and most accurate code to use. The payer can assign a reasonable reimbursement value depending on the crosswalk you use as your example CPT code for a