How To Use CPT Code 27695

CPT 27695 describes the primary repair of a disrupted ligament in the ankle joint. 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 27695?

CPT 27695 is used to describe the primary repair of a single collateral ligament in the ankle joint that has been disrupted due to an acute injury, such as a dislocation or sprain. The purpose of this procedure is to restore function and relieve pain in the ankle joint.

2. Official Description

The official description of CPT code 27695 is: ‘Repair, primary, disrupted ligament, ankle; collateral.’

3. Procedure

1. The provider begins by making an incision over the lateral or medial malleolus, being careful not to damage the sural nerve.
2. Next, the provider identifies and exposes the remnant of the disrupted collateral ligament by dissecting the anterior tissues.
3. The transverse ligament is then incised, and a periosteal flap is folded over the anterior fibula, overlapping the edges.
4. The provider proceeds to debride the distal tip of the fibula using a curette and surgical blade.
5. Decortication of the bone is performed using a burr to create a bleeding bony bed for healing and suture anchor placement.
6. A drill hole is made in the fibula, and the remnant of the collateral ligament is sutured and anchored in the holes in the distal fibula.
7. Finally, the incision is closed.

4. Qualifying circumstances

CPT 27695 is performed when there is a disruption of a single collateral ligament in the ankle joint due to an acute injury. This procedure is appropriate for patients who require primary repair to restore function and alleviate pain in the ankle joint.

5. When to use CPT code 27695

CPT code 27695 should be used when the provider performs the primary repair of a disrupted collateral ligament in the ankle joint. It is important to note that this code is specific to the repair of a single collateral ligament. If both collateral ligaments require repair, CPT code 27696 should be used instead.

6. Documentation requirements

To support a claim for CPT 27695, the provider must document the following information:

• The diagnosis indicating the disruption of the collateral ligament in the ankle joint
• A detailed description of the procedure performed, including the specific steps taken
• The date of the procedure
• The start and end time of the procedure
• Any additional findings or complications encountered during the procedure
• The provider’s signature

7. Billing guidelines

When billing for CPT 27695, it is important to ensure that the procedure meets the criteria for primary repair of a disrupted collateral ligament in the ankle joint. Modifier 62, Two surgeons, should be appended if the provider is acting as a cosurgeon with another provider. It is also essential to review the Medicare Physician Fee Schedule and other payer guidelines to determine the appropriate reimbursement and billing requirements for this procedure.

8. Historical information

CPT 27695 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 sustains a sprained ankle and undergoes primary repair of the disrupted collateral ligament in the ankle joint.
2. An individual dislocates their ankle and requires primary repair of the disrupted collateral ligament to restore stability and function.
3. A patient experiences acute pain in their ankle due to a disrupted collateral ligament and undergoes primary repair to alleviate their symptoms.
4. An athlete injures their ankle during a sports activity and undergoes primary repair of the disrupted collateral ligament to facilitate their return to sports.
5. A patient presents with a chronic ankle instability and undergoes primary repair of the disrupted collateral ligament to improve their overall ankle function.
6. An individual sustains a traumatic injury to their ankle, resulting in a disrupted collateral ligament that requires primary repair for proper healing and recovery.
7. A patient with a history of ankle sprains undergoes primary repair of the disrupted collateral ligament to prevent future instability and recurrent injuries.
8. An individual experiences persistent pain and limited mobility in their ankle due to a disrupted collateral ligament and undergoes primary repair to improve their quality of life.
9. A patient with an acute ankle injury undergoes primary repair of the disrupted collateral ligament to restore normal joint function and prevent long-term complications.
10. An athlete sustains a ligamentous injury to their ankle during training and undergoes primary repair of the disrupted collateral ligament to ensure a successful return to their sport.