How To Use CPT Code 27698

CPT 27698 describes the procedure for a secondary repair of a disrupted collateral ligament in the ankle joint. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 27698?

CPT 27698 is used to describe a secondary repair procedure for a disrupted collateral ligament in the ankle joint. This procedure involves the mobilization of other tendons to replace the damaged collateral ligament. It is performed when the injury is not recent and aims to restore function and relieve pain in the ankle joint.

2. Official Description

The official description of CPT code 27698 is: ‘Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure).’ This code specifically refers to the secondary repair of a disrupted collateral ligament in the ankle joint.

3. Procedure

1. The provider begins by making an incision over the lateral malleolus, extending it down to the deep fascia, taking care not to damage the sural nerve.
2. Next, the provider identifies and exposes the peroneal tendon.
3. The peroneal tendon is harvested as the injury is chronic and there is insufficient ligament remaining for a repair.
4. The provider then debrides the distal tip of the fibula using a curette and a surgical blade.
5. To provide a bleeding bony bed for healing and suture anchor placement, the provider decorticates the bone using a burr.
6. Drill holes are made in the fibula.
7. The peroneal tendon is transferred through the burr holes and anchored to the distal fibula.
8. Finally, the wound is closed.

4. Qualifying circumstances

CPT 27698 is performed when there is a disrupted collateral ligament in the ankle joint that requires a secondary repair. This procedure is typically done when the injury is not recent and the ligament cannot be repaired directly. The provider must mobilize other tendons, such as the peroneal tendon, to replace the damaged collateral ligament.

5. When to use CPT code 27698

CPT code 27698 should be used when a secondary repair of a disrupted collateral ligament in the ankle joint is performed. This code is appropriate when the injury is not recent and the ligament cannot be repaired directly. It is important to accurately document the procedure and ensure that it meets the criteria for using this specific CPT code.

6. Documentation requirements

To support a claim for CPT 27698, the provider must document the following information:

• Description of the disrupted collateral ligament and the need for a secondary repair
• Details of the procedure, including the incision, tendon harvest, debridement, decortication, and anchoring
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 27698, ensure that the procedure meets the criteria for a secondary repair of a disrupted collateral ligament in the ankle joint. It is important to accurately document the procedure and provide any necessary supporting documentation. Follow the appropriate coding and billing guidelines for reporting this procedure.

8. Historical information

CPT 27698 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition. This code specifically describes the secondary repair of a disrupted collateral ligament in the ankle joint.

9. Examples

1. A patient with a chronic disrupted collateral ligament in the ankle joint undergoes a secondary repair procedure using the peroneal tendon.
2. A provider performs a secondary repair of a disrupted collateral ligament in the ankle joint for a patient who has been experiencing persistent pain and instability.
3. After an injury to the ankle joint, a patient undergoes a primary repair procedure for the disrupted collateral ligament. However, the ligament does not heal properly, and a secondary repair using the peroneal tendon is performed.
4. A provider performs a secondary repair of a disrupted collateral ligament in the ankle joint for a patient who had previously undergone a primary repair but experienced a recurrence of symptoms.
5. A patient with a chronic disrupted collateral ligament in the ankle joint undergoes a secondary repair procedure using a tendon graft.
6. Following a failed primary repair of a disrupted collateral ligament in the ankle joint, a provider performs a secondary repair using the peroneal tendon to restore stability and function.
7. A patient with a chronic disrupted collateral ligament in the ankle joint undergoes a secondary repair procedure using a synthetic graft.
8. After an injury to the ankle joint, a patient undergoes a primary repair procedure for the disrupted collateral ligament. However, the ligament does not heal properly, and a secondary repair using a tendon graft is performed.
9. A provider performs a secondary repair of a disrupted collateral ligament in the ankle joint for a patient who had previously undergone a primary repair but experienced persistent pain and instability.
10. A patient with a chronic disrupted collateral ligament in the ankle joint undergoes a secondary repair procedure using an allograft.