APMA News - March/April 2024 - 39

coding update
similar RVU work code. It is important to compare
the coding for the payer; it helps enable the insurance
to best price the unlisted procedure.
The most recent, newer approaches to tendon
repair, grafting, or similar procedures may not
always be reflected in the code sets offered, or
acceptable to use for precise code selection. You
must always remember to code to the exact descriptor
and not approximate your coding.
Common tendon repair CPT codes can be
found in the APMA Coding Resource Center
(CRC). The CRC will also provide all global periods,
RVU values, and a quick look-up of the CCI
(Correct Coding Initiative) for modifier needs
when appropriate.
CPT 27650 Repair, primary, open or percutaneous,
ruptured Achilles tendon
CPT 27652 Repair, primary, open or percutaneous,
ruptured Achilles tendon; with graft
(includes obtaining graft)
CPT 27654 Repair, secondary, Achilles tendon,
with or without graft
CPT 27656 Repair, fascial defect of leg
CPT 27658 Repair, flexor tendon, leg; primary,
without graft, each tendon
CPT 27659 Repair, flexor tendon, leg; secondary,
with or without graft, each tendon
CPT 27664 Repair, extensor tendon, leg; primary,
without graft, each tendon
CPT 27665 Repair, extensor tendon, leg; secondary,
with or without graft, each tendon.
These codes all have 90-day global periods as
well. A key point is whether the code is noted
with or without graft. When " with graft " is included,
you cannot bill additionally for the graft application.
You or the facility that purchases the graft
may be able to bill the appropriate HCPCS code
for the graft when it is not deemed to be included
in the service code.
There are additional considerations to keep in
mind when coding for tendon repairs, such as:
* At what anatomical level am I working?
* On what tendon group am I working, i.e., extensors,
flexors, invertors, etc.?
* What was truly done, e.g., was it a tenotomy,
tenolysis, transfer with repair of injury?
All of the above questions are important factors
to consider when choosing the proper CPT code.
The timing of the approach taken compared to
when the injury/damage occurred also matters.
Remember, providers cannot select the code that
merely approximates the service offered; it must be
selected accurately.
Key takeaways when coding for a tendon repair
include:
* What is the time frame of the injury?
* What is the event that led to the tendon needing
repair?
* Is this an acute, primary approach, or is it one
dealing with an older chronic injury needing
secondary repair?
Interested in more complimentary coding
education and guidance as part of your APMA
membership? Check out all past coding webinars
at www.apma.org/webinars, as well as
the most recent and ongoing coding webinar
series, Coding Refreshers, hosted by the APMA
Coding Committee, available at www.apma.org/
CodingRefreshers.
Endnotes
1
Goldsmith, Harry. Coding Surgical Scenarios.
May 2017, https://www.apma.org/files/Coding%20
Surgical%20Scenarios.pdf.
APMA.ORG
apmanews
39

http://www.apma.org/webinars http://www.apma.org/CodingRefreshers http://www.apma.org/CodingRefreshers https://www.apma.org/files/Coding%20Surgical%20Scenarios.pdf https://www.apma.org/files/Coding%20Surgical%20Scenarios.pdf http://www.APMA.ORG

APMA News - March/April 2024

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