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Tenolysis is a surgical procedure aimed at freeing a tendon from the surrounding tissue that may be restricting its movement. This procedure is particularly relevant for flexor or extensor tendons located in the leg and/or ankle. The primary goal of tenolysis is to restore motion to the ankle, foot, and/or toes by releasing scar tissue that has formed due to trauma or various disease processes. In the context of CPT® Code 27681, the procedure involves the tenolysis of multiple tendons, which is performed through separate incisions. This approach allows for targeted intervention on each affected tendon, ensuring that the surgical technique is precise and effective in alleviating the restrictions caused by adhesions. The procedure typically begins with an incision made over the affected tendons, followed by careful dissection of the surrounding soft tissues to expose the tendons. Once identified, the adhesions that bind the tendon to the surrounding structures are severed, allowing for improved range of motion. After the surgical intervention, the wound is meticulously closed in layers, and a dressing is applied to promote healing and protect the surgical site.
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Tenolysis, as described by CPT® Code 27681, is indicated for patients experiencing restricted motion in the ankle, foot, and/or toes due to the presence of scar tissue surrounding multiple flexor or extensor tendons. The following conditions may warrant this procedure:
The procedure for tenolysis of multiple tendons, as outlined in CPT® Code 27681, involves several key steps that ensure effective release of the affected tendons. Each step is critical to achieving the desired outcome of restoring motion.
Post-procedure care following tenolysis of multiple tendons involves monitoring the surgical site for signs of infection and ensuring proper healing. Patients are typically advised to follow specific rehabilitation protocols to regain strength and mobility in the affected area. This may include physical therapy to enhance range of motion and functional recovery. The surgeon may also provide guidelines on activity restrictions and the use of dressings or splints to protect the surgical site during the initial recovery phase. Regular follow-up appointments are essential to assess healing progress and to make any necessary adjustments to the rehabilitation plan.
| Short Descr | RELEASE OF LOWER LEG TENDONS | Medium Descr | TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN | Long Descr | Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision[s]) | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 |
| 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. | 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) | SG | Ambulatory surgical center (asc) facility service | 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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| 2013-01-01 | Changed | Minor grammatical description change. |
| Pre-1990 | Added | Code added. |
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