© Copyright 2025 American Medical Association. All rights reserved.
Ankle disarticulation, as defined by CPT® Code 27889, is a surgical procedure that involves the complete removal of the foot at the ankle joint. This procedure is typically indicated in cases where there is severe trauma, infection, or other conditions that compromise the viability of the foot. The process begins with the careful marking of incision lines on the skin to guide the surgical approach. Surgeons then make incisions through the skin and underlying soft tissues, allowing access to the deeper structures. The dissection continues down to the muscle layers, where muscle compartments are identified and isolated. This meticulous approach ensures that the muscles are divided appropriately to facilitate the removal of the foot while preserving as much surrounding tissue as possible. During the procedure, neurovascular structures, including nerves and blood vessels, are carefully identified and isolated. It is crucial to separate the nerves from the arteries to prevent any pulsatile irritation that could lead to complications. The nerves are transected and allowed to retract into the surrounding soft tissues, while the blood vessels are ligated and divided to control bleeding. Following the removal of the forefoot, midfoot, talus, and calcaneus, the articular cartilage of the tibia is excised to prepare the site for closure. Finally, the remaining tendons and muscles are reattached to the bone, and the heel pad is rotated and sutured over the end of the tibia to provide a protective covering. This comprehensive approach ensures that the procedure is performed with precision, aiming for optimal outcomes for the patient.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of ankle disarticulation (CPT® Code 27889) is indicated for several specific conditions that necessitate the removal of the foot at the ankle joint. These indications include:
The ankle disarticulation procedure involves several critical steps to ensure a successful outcome. The steps are as follows:
After the ankle disarticulation procedure, patients typically require careful monitoring and post-operative care to ensure proper healing. This may include pain management, wound care, and physical therapy to aid in recovery. The expected recovery period can vary based on individual patient factors, but rehabilitation is essential to help the patient adapt to the changes following the disarticulation. Follow-up appointments will be necessary to assess healing and to address any complications that may arise during the recovery process.
| Short Descr | ANKLE DISARTICULATION | Medium Descr | ANKLE DISARTICULATION | Long Descr | Ankle disarticulation | 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 157 - Amputation of lower extremity |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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.) | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | GW | Service not related to the hospice patient's terminal condition | 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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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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