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08/28/2004    Ted Couluris, DPM

Peroneal Rupture/Dislocation Repair

Query: Peroneal Rupture/Dislocation Repair

I have a question regarding proper coding for an
open repair of a peroneal brevis tendon rupture
accompanied by a fibular groove deepening
procedure and reefing of the superior peroneal
retinaculum. Can I code these as three or two
procedures, or only one?

The only codes I have found were - CPT 28200
(repair, tendon, flexor, foot; primary or
secondary, without free graft, each tendon) & -
CPT 27676 (repair of dislocating peroneals with
fibular osteotomy - although I deepened the
groove and did not perform the osteotomy).

Are these codes correct? Is the reefing
procedure "included", or does it have a separate
code to bill? Is there a single code that
includes all the work I performed?

Ted Couluris, DPM
Clearwater, FL

Codingline Response: If there is both a tendon
rupture and evidence of tendon dislocation, the
two codes you listed would be correct. I would
not recommend any additional coding for
the "reefing" procedure. This is incidental to
the repair of dislocating peroneal tendon. The
repair of the ruptured peroneal tendon is
justified if you really did find a defect of the
tendon that required open repair.

Howard Zlotoff, DPM
Camp Hill, PA

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