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Hamstring tenotomy is a surgical procedure aimed at addressing flexion deformities of the knee, which can significantly impact mobility and function. The hamstring group consists of three primary muscles: the biceps femoris, semitendinosus, and semimembranosus. These muscles play a crucial role in extending the knee and flexing the thigh, making them essential for various movements such as walking, running, and jumping. In the context of CPT® Code 27392, the procedure involves an open tenotomy, which is a surgical intervention where multiple tendons of the hamstring are divided. This specific code is utilized when the tenotomy is performed bilaterally, meaning that multiple tendons in both legs are addressed during the same surgical session. The procedure is typically indicated for patients who have significant knee flexion deformities that cannot be corrected through conservative measures. The surgical approach involves making an incision in the popliteal crease, which is located at the back of the knee, allowing for direct access to the tendon insertion sites. This detailed understanding of the hamstring tenotomy procedure is essential for accurate medical coding and billing, ensuring that healthcare providers are appropriately reimbursed for the services rendered.
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Hamstring tenotomy is indicated for patients experiencing flexion deformities of the knee, which may result from various conditions affecting the musculoskeletal system. The following are specific indications for performing this procedure:
The procedure for an open hamstring tenotomy involves several critical steps to ensure successful tendon division and patient safety. The following outlines the procedural steps:
Following the hamstring tenotomy, patients are typically monitored for any immediate complications. Post-procedure care includes keeping the leg immobilized in the cast to promote healing of the divided tendons. Patients may be advised on pain management strategies and instructed on how to care for the cast. Rehabilitation and physical therapy may be recommended after an appropriate healing period to restore strength and function to the knee and surrounding muscles. Regular follow-up appointments are essential to monitor recovery progress and address any concerns that may arise during the healing process.
| Short Descr | INCISION OF THIGH TENDONS | Medium Descr | TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI | Long Descr | Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 2 - 150% payment adjustment does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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