APMA News - March/April 2024 - 38

coding update
Tendon Repair Coding: Primary
Versus Secondary Repair
By Jonathan Huey, DPM, and Michael King, DPM
Some confusion continues to exist about what
constitutes a primary tendon repair versus a secondary
repair. CPT literature relates the following
directions when determining the correct code for
reimbursement:
Primary repair: Any repair of an acute injury
completed within the first 24 hours after the injury.
Delayed primary repair: A repair performed within
24 hours to two weeks of the injury.
Secondary repair: A repair performed after two
weeks of injury.
APMA has provided additional guidance to
members in past coding education on this subject1
indicating that primary repairs usually involve direct
38
apmanews
MARCH/APRIL 2024
,
surgical correction of the injury, while secondary
repairs may include tendon grafts or other more
complex procedures.
Below are the most common types of tendon
repair code options for the ankle and lower leg.
The key element is the time frame of the surgical
approach and then what is done, using the
most exact code possible. Should no code exist,
using the unlisted surgical code (CPT 27999) is
an option. The unlisted code requires a manual
review by the payer but is often the best and most
accurate code to use. The payer can assign a
reasonable reimbursement value depending on the
crosswalk you use as your example CPT code for a

APMA News - March/April 2024

Table of Contents for the Digital Edition of APMA News - March/April 2024

Contents
APMA News - March/April 2024 - Cover1
APMA News - March/April 2024 - Cover2
APMA News - March/April 2024 - 1
APMA News - March/April 2024 - 2
APMA News - March/April 2024 - 3
APMA News - March/April 2024 - 4
APMA News - March/April 2024 - Contents
APMA News - March/April 2024 - 6
APMA News - March/April 2024 - 7
APMA News - March/April 2024 - 8
APMA News - March/April 2024 - 9
APMA News - March/April 2024 - 10
APMA News - March/April 2024 - 11
APMA News - March/April 2024 - 12
APMA News - March/April 2024 - 13
APMA News - March/April 2024 - 14
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APMA News - March/April 2024 - 68
APMA News - March/April 2024 - Cover3
APMA News - March/April 2024 - Cover4
APMA News - March/April 2024 - A1
APMA News - March/April 2024 - A2
APMA News - March/April 2024 - A3
APMA News - March/April 2024 - A4
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