How To Use CPT Code 27686

CPT 27686 describes the lengthening or shortening of multiple tendons in the leg or ankle through the same incision. 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 27686?

CPT 27686 is used to describe a surgical procedure in which a provider repairs contracture or other deformities in multiple tendons in the leg or ankle through the same incision. The purpose of this procedure is to restore function and relieve pain in the affected area.

2. Official Description

The official description of CPT code 27686 is: ‘Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each.’

3. Procedure

1. The provider begins by making an incision through the subcutaneous tissue down to the tendon sheath of the affected tendon.
2. If the tendon needs to be lengthened, the provider makes a Z-shaped incision in the tendon and assesses the length by asking the patient to move their foot.
3. If the tendon needs to be shortened, the provider cuts away the extra length of the tendon.
4. In both cases, the provider reapproximates the cut ends of the tendon with sutures in an end-to-end repair.
5. The provider also repairs the tendon sheath with sutures.
6. Any bleeding is controlled, and the incision is closed in layers.
7. A short leg walking cast is applied to support the healing process.

4. Qualifying circumstances

CPT 27686 is performed on patients with contracture or other deformities in multiple tendons of the leg or ankle. These deformities may be congenital or acquired. The procedure is aimed at restoring function and relieving pain in the affected area.

5. When to use CPT code 27686

CPT code 27686 should be used when a provider performs the lengthening or shortening of multiple tendons in the leg or ankle through the same incision. It is important to accurately document the specific tendons involved and the approach taken during the procedure.

6. Documentation requirements

To support a claim for CPT 27686, the provider must document the following information:

• The specific tendons involved in the procedure
• The approach taken (lengthening or shortening)
• The date of the procedure
• Details of the incision and repair process
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 27686, ensure that the procedure meets the criteria for this code. It is important to accurately document the specific tendons involved and the approach taken during the procedure. Modifier 62 should be appended if the provider is acting as a cosurgeon with another provider. Medicare and most other payers reimburse procedures coded with modifier 62 at 125 percent of the regular fee schedule amount.

8. Historical information

CPT 27686 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 provider performs the lengthening of multiple tendons in the leg through the same incision to correct contracture in a patient with cerebral palsy.
2. A surgeon shortens multiple tendons in the ankle through the same incision to relieve pain and improve function in a patient with equinus deformity.
3. A podiatrist performs the lengthening of multiple tendons in the leg through the same incision to address contracture in a patient with Charcot-Marie-Tooth disease.
4. An orthopedic surgeon shortens multiple tendons in the ankle through the same incision to correct deformity in a patient with rheumatoid arthritis.
5. A foot and ankle specialist performs the lengthening of multiple tendons in the leg through the same incision to address contracture in a patient with spastic diplegia.
6. A provider shortens multiple tendons in the ankle through the same incision to relieve pain and improve function in a patient with post-traumatic deformity.
7. An orthopedic surgeon performs the lengthening of multiple tendons in the leg through the same incision to correct contracture in a patient with muscular dystrophy.
8. A podiatrist shortens multiple tendons in the ankle through the same incision to address deformity in a patient with osteoarthritis.
9. A foot and ankle specialist performs the lengthening of multiple tendons in the leg through the same incision to correct contracture in a patient with polio.
10. An orthopedic surgeon shortens multiple tendons in the ankle through the same incision to relieve pain and improve function in a patient with post-stroke spasticity.