AHA Coding Clinic® for HCPCS - 2021 Quarter 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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Article Overview
This premium article explains a coding question related to hindfoot arthrodesis performed for Charcot arthropathy of the ankle. It is aimed at coders, billers, and reimbursement staff who need to understand how the procedure is discussed in CPT terms and how combined ankle and subtalar fusion is addressed in a surgical coding context.
Why This Topic Matters
Hindfoot fusion cases can involve multiple joints and fixation methods, so correct procedure reporting is important for accurate coding review and claims processing. This article helps readers evaluate the coding question raised by a combined ankle and subtalar arthrodesis case.
What You Will Learn
- The clinical context of hindfoot arthrodesis for Charcot arthropathy
- How the article frames a CPT coding question involving ankle and subtalar fusion
- The type of surgical approach and fixation method described in the case
- The broader coding issue raised when multiple hindfoot joints are fused in one operation
Who Should Read This
- Medical coders
- Coding auditors
- Orthopedic surgery billers
- Reimbursement specialists
Codes Discussed
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