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The procedure described by CPT® Code 27696 involves the primary repair of disrupted ligaments in the ankle, specifically addressing both collateral ligaments. The ankle joint is supported by three groups of ligaments: the deltoid or medial collateral ligament, which provides medial stability; the three lateral collateral ligaments (anterior talofibular, posterior talofibular, and calcaneofibular ligaments), which offer lateral support; and the syndesmotic ligaments, which help maintain the alignment of the ankle. When any of these ligaments are disrupted, it can lead to instability in the ankle joint, resulting in pain and impaired function. This code is specifically used when both collateral groups of ligaments are affected and require surgical intervention. The procedure typically involves making an incision over the affected area, exposing the damaged ligaments, and performing necessary debridement of any injured tissue. The ligaments are then repaired using sutures, or if they have detached from the bone, they may be reattached using a bone screw. It is important to note that CPT® Code 27696 is designated for the primary repair of these ligaments, distinguishing it from other codes that may apply to different scenarios or types of ligament disruptions.
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The procedure associated with CPT® Code 27696 is indicated for patients who have experienced a disruption of both collateral ligaments in the ankle. This condition may arise from various causes, including traumatic injuries such as ankle sprains or fractures that compromise the integrity of the ligaments. Symptoms that may prompt the need for this procedure include significant ankle instability, pain during weight-bearing activities, swelling, and difficulty in performing daily activities due to compromised joint function.
The procedure for CPT® Code 27696 involves several critical steps to ensure the effective repair of both collateral ligaments in the ankle. First, the surgeon makes an incision over the lateral or medial aspect of the ankle, depending on the specific ligaments that are disrupted. This incision allows for direct access to the affected ligaments. Once the incision is made, the surgeon carefully exposes the injured ligaments, taking care to identify the extent of the damage. Following exposure, any damaged tissue is debrided, which involves the removal of unhealthy or necrotic tissue to promote healing and prepare the ligament for repair. After debridement, the surgeon proceeds to repair the ligaments using sutures, ensuring that they are securely reattached to restore stability to the ankle joint. In cases where the ligament has completely detached from the bone, the surgeon may utilize a bone screw to reattach the ligament to its original position on the bone, further enhancing the stability and function of the ankle joint.
After the completion of the procedure coded as CPT® 27696, patients typically require a period of post-operative care to ensure proper healing and recovery. This may include immobilization of the ankle joint using a splint or cast to prevent movement and protect the surgical site. Patients are often advised to follow a rehabilitation program that includes physical therapy to regain strength and mobility in the ankle. Pain management strategies may also be implemented to address any discomfort following the surgery. The expected recovery time can vary based on the individual’s overall health and adherence to post-operative instructions, but patients should anticipate a gradual return to normal activities as healing progresses. Regular follow-up appointments with the healthcare provider are essential to monitor the healing process and address any complications that may arise.
| Short Descr | REPAIR OF ANKLE LIGAMENTS | Medium Descr | RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS | Long Descr | Repair, primary, disrupted ligament, ankle; both collateral ligaments | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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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| Pre-1990 | Added | Code added. |
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