AHA Coding Clinic® for HCPCS - 2021 Issue 2; Ask the Editor

Ankle and subtalar arthrodesis

A patient with Charcot arthropathy of the right ankle presented for ankle and subtalar fusions using a hindfoot arthrodesis nail. The lateral aspect of the ankle was accessed over the fibula and the distal fibula was excised. A complete resection of both the ankle and subtalar joints was made with exposure of subchondral bone. The Achilles tendon was lengthened to allow for realignment through the lateral incision. Once the limb was aligned, a guidepin was placed for the intramedullary hindfoot nail. Holes were drilled, the nail was placed into position and a calcaneal bolt was inserted into the distal hole, interlocking the nail. A more proximal screw was placed into the calcaneus completing the distal fixation. A final screw was placed in the most proximal hole in the tibia completing the fixation with the hindfoot fusion nail. When both an ankle and subtalar arthrodesis are performed, is it appropriate to assign both CPT codes 27870 and 28725? In addition, would CPT code 27685 be reported to capture the Achilles tendon lengthening? ...

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