How To Use CPT Code 27654

CPT 27654 describes the repair of the Achilles tendon for the second time, with or without the use of a graft. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27654?

CPT 27654 can be used to describe the repair of the Achilles tendon for the second time, either with or without the use of a graft. This code is used when the previous repair was unsuccessful or when the patient reinjured the tendon, requiring a secondary repair.

2. Official Description

The official description of CPT code 27654 is: ‘Repair, secondary, Achilles tendon, with or without graft.’

3. Procedure

1. The provider begins by opening the old incision and identifying the site of the previous repair.
2. They remove the old sutures and any previously placed graft, if applicable.
3. The ruptured tendon is debrided, and any scar tissue is removed.
4. If a graft is needed, the provider may harvest it from a separate location, such as the fascia or plantar tendon.
5. The graft site incision is closed with sutures.
6. If a graft is used, it is incorporated into the Achilles tendon.
7. Any bleeding is controlled, and the soft tissue is closed with sutures.
8. The skin incision is closed.
9. The patient’s leg is immobilized in a short leg cast, splint, or brace for at least two weeks.

4. Qualifying circumstances

CPT 27654 is performed when the previous repair of the Achilles tendon was unsuccessful or when the patient reinjured the tendon, requiring a secondary repair. The procedure may involve the use of a graft, which can be harvested from a separate location. The provider must document the need for the secondary repair and any relevant details in the patient’s medical record.

5. When to use CPT code 27654

CPT code 27654 should be used when a provider performs a secondary repair of the Achilles tendon, either with or without the use of a graft. This code is specifically for cases where the previous repair was unsuccessful or when the patient reinjured the tendon.

6. Documentation requirements

To support a claim for CPT 27654, the provider must document the following information:

• Reason for the secondary repair, such as unsuccessful previous repair or reinjury
• Details of the procedure, including any graft used and its source
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27654, ensure that the procedure meets the criteria for a secondary repair of the Achilles tendon. If a graft is used, do not report the harvesting of the graft separately, as it is included in the code. It is important to follow the specific guidelines provided by the payer and to use the appropriate modifiers if necessary.

8. Historical information

CPT 27654 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a secondary repair of the Achilles tendon without the use of a graft due to an unsuccessful previous repair.
2. A provider performs a secondary repair of the Achilles tendon with the use of a graft harvested from the plantar tendon.
3. After reinjuring their Achilles tendon, a patient requires a secondary repair with a graft obtained from the fascia.
4. A provider performs a secondary repair of the Achilles tendon without the use of a graft due to a failed previous repair.
5. Following a reinjury of the Achilles tendon, a patient undergoes a secondary repair with a graft harvested from the plantar tendon.
6. A provider performs a secondary repair of the Achilles tendon with the use of a graft obtained from the fascia.
7. Due to an unsuccessful previous repair, a patient requires a secondary repair of the Achilles tendon without the use of a graft.
8. A provider performs a secondary repair of the Achilles tendon with the use of a graft harvested from the plantar tendon.
9. After reinjuring their Achilles tendon, a patient undergoes a secondary repair with a graft obtained from the fascia.
10. A provider performs a secondary repair of the Achilles tendon without the use of a graft due to a failed previous repair.