How To Use CPT Code 27690

CPT 27690 describes the transfer or transplant of a single tendon, specifically the anterior tibial extensors into the midfoot. 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 27690?

CPT 27690 can be used to describe a surgical procedure in which a single tendon is transferred or transplanted. This procedure is typically performed to restore function that has been lost due to a diseased, paralyzed, or injured tendon. In the case of CPT 27690, the anterior tibial extensors are transferred into the midfoot.

2. Official Description

The official description of CPT code 27690 is: ‘Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)’. This code specifically refers to the transfer or transplant of a single tendon, with the redirection or rerouting of muscle, in a superficial location.

3. Procedure

1. The procedure begins with the patient being appropriately prepped and anesthetized.
2. The provider makes a long incision on the anterior leg or ankle over the tendon that needs to be transferred.
3. The provider exposes and harvests the required length of tendon.
4. A second incision is made on the lateral ankle over the area of the diseased, paralyzed, or inactive tendon.
5. The provider excises the diseased tendon.
6. A drill hole is made in the lateral fibula.
7. The harvested tendon is carefully prepared, divided, and rerouted through the drill hole in the fibula.
8. The provider places the foot in the correct position and asks the patient to move their foot to check the correct length and tension of the tendon.
9. The tendon is sutured in place.
10. The wound is closed and the foot is placed in a half leg walking cast for two to six weeks to allow for proper healing.

4. Qualifying circumstances

CPT 27690 is typically performed on patients who have a diseased, paralyzed, or injured tendon that requires restoration of function. The procedure involves the transfer or transplant of a single tendon, specifically the anterior tibial extensors into the midfoot. It is important to note that this code is specific to superficial tendon transfers or transplants.

5. When to use CPT code 27690

CPT code 27690 should be used when a provider performs a transfer or transplant of a single tendon, specifically the anterior tibial extensors into the midfoot. This code is appropriate when the procedure involves the redirection or rerouting of muscle and is performed in a superficial location. It is important to ensure that the documentation accurately reflects the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT code 27690, the provider must document the following information:

• Patient’s diagnosis necessitating the tendon transfer or transplant
• Details of the procedure, including the specific tendon transferred or transplanted
• Incision locations and lengths
• Drill hole placement
• Confirmation of correct length and tension of the tendon
• Method of closure
• Post-procedure instructions, such as the use of a walking cast
• Any additional relevant information or complications

7. Billing guidelines

When billing for CPT code 27690, it is important to ensure that the documentation supports the use of this specific code. Additionally, it is important to follow any specific billing guidelines provided by the payer. Modifier 62, Two surgeons, may be appended if the provider is acting as a cosurgeon with another provider. It is important to coordinate with the other surgeon’s staff to ensure accurate billing and reimbursement.

8. Historical information

CPT code 27690 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a paralyzed anterior tibial tendon undergoes a transfer of the tendon into the midfoot to restore function.
2. A patient with a diseased anterior tibial tendon undergoes a transplant of the tendon into the midfoot to improve mobility.
3. A patient with an injured anterior tibial tendon undergoes a transfer of the tendon into the midfoot to regain strength and stability.
4. A patient with a damaged anterior tibial tendon undergoes a transplant of the tendon into the midfoot to alleviate pain and improve function.
5. A patient with a weakened anterior tibial tendon undergoes a transfer of the tendon into the midfoot to enhance mobility and prevent further damage.
6. A patient with a degenerative anterior tibial tendon undergoes a transplant of the tendon into the midfoot to restore normal foot mechanics.
7. A patient with an inactive anterior tibial tendon undergoes a transfer of the tendon into the midfoot to regain control and function.
8. A patient with a paralyzed anterior tibial tendon undergoes a transplant of the tendon into the midfoot to improve gait and stability.
9. A patient with an injured anterior tibial tendon undergoes a transfer of the tendon into the midfoot to restore balance and strength.
10. A patient with a diseased anterior tibial tendon undergoes a transplant of the tendon into the midfoot to alleviate symptoms and improve quality of life.