There is a debate in my office about how to code this procedure. This is a free-standing ASC. A DPM is doing the surgery. This is the entire part that is relevant to the procedure. I realize the note isn’t very good. I spoke to the DPM about the procedure. The incision is being made in the lower (mid) calf. He says he slices the gastrocnemius tendon and it is a 5 minute procedure.

DESCRIPTION OF THE GASTROCNEMIUS RESECTION ON THE LEFT FOOT: A superficial skin incision was placed over the gastrocnemius tendon. This was done with superficial skin blade with sharp and blunt dissection deeply. The subcutaneous tissue was reflected back and was brought into view the gastrocnemius tendon which was noted and appreciated and transected in toto utilizing a #15 blade and Metzenbaum scissor. Once this was completed, the wound was then closed in layers utilizing 4-0 Polysorb in the subcutaneous tissue and the skin was closed with simple interrupted sutures of 4-0 nylon.

The DPM assured me it was 27612. I showed him the description of that code and he agreed that he isn’t doing that procedure.

Based on the name of the procedure, it appears to be 27687. However, reading the description of 27687, I’m inclined to say it’s NOT that code either. The doctor is for sure not doing the Strayer Procedure. Even still, that code appears to be much more involved. I did ask the doctor how deep he is going and it’s about 1/2 inch. He isn’t doing anything to the gastrocnemius muscle itself.

29999 would be used for a endoscopic gastrocnemius recession. And it’s not endoscopic. However, I’m leaning towards this code because it seems the most appropriate as the other codes don’t really seem to work in my opinion.

I will say it’s difficult for us to get paid for unlisted procedures, so if there is a more appropriate code, I’d rather use that. I’ve been doing a lot of research and I’m not seeing anything that really fits this situation.

Any thoughts? Thank you in advance.