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The Achilles tendon is recognized as the largest tendon in the human body, playing a crucial role in connecting the gastrocnemius and soleus muscles located in the calf to the calcaneus, or heel bone. This tendon is essential for various activities such as walking, running, and jumping, as it facilitates movement and stability. Over time, factors such as aging or a sedentary lifestyle can lead to a weakening and thinning of the Achilles tendon, making it susceptible to injuries. One of the most prevalent injuries associated with this tendon is a complete tear or rupture, which can significantly impair mobility and function. The procedure described by CPT® Code 27650 involves the primary repair of a ruptured Achilles tendon, which can be performed using either an open or percutaneous approach. In the open technique, a longitudinal skin incision is made over the lower leg and ankle, allowing for direct access to the tendon. The ruptured ends of the tendon are then exposed, debrided, and sutured together using heavy nonabsorbable sutures. Alternatively, the percutaneous approach involves making multiple small stab wounds over the posterior aspect of the ankle, through which sutures are passed to repair the tendon. This method minimizes tissue disruption and is often associated with a shorter recovery time. Both techniques aim to restore the integrity of the Achilles tendon, thereby enabling the patient to regain normal function and mobility.
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The procedure described by CPT® Code 27650 is indicated for the repair of a ruptured Achilles tendon. This condition typically arises from acute injuries, often resulting in significant pain and loss of function in the affected limb. The following are specific indications for performing this procedure:
The procedure for repairing a ruptured Achilles tendon as described by CPT® Code 27650 can be performed using either an open or percutaneous approach. Each method involves specific steps to ensure effective repair of the tendon.
After the repair of the ruptured Achilles tendon, whether performed via the open or percutaneous approach, post-procedure care is essential for optimal recovery. Patients are typically placed in a short leg nonweight-bearing cast to immobilize the ankle and prevent movement that could jeopardize the repair. The duration of casting may vary based on the surgeon's protocol and the patient's healing progress. Rehabilitation often begins with gentle range-of-motion exercises, gradually progressing to strengthening activities as healing allows. Follow-up appointments are crucial to monitor the healing process and to make any necessary adjustments to the rehabilitation plan. Patients are advised to avoid putting weight on the affected leg until cleared by their healthcare provider to ensure proper healing and to minimize the risk of complications.
| Short Descr | REPAIR ACHILLES TENDON | Medium Descr | REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON | Long Descr | Repair, primary, open or percutaneous, ruptured Achilles tendon; | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AI | Principal physician of record | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | SA | Nurse practitioner rendering service in collaboration with a physician | SG | Ambulatory surgical center (asc) facility service | T1 | Left foot, second digit | T5 | Right foot, great toe | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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