Reconstruction of the ATFL and CFL

Reconstruction of the ATFL and CFL

September 30, 2021

Question:
Our foot and ankle surgeon performed a reconstruction of the ATFL and the CFL ligament in the left leg for a chronic injury. We are looking at CPT codes and wondering if we should be reporting CPT code 27696 or CPT code 27698. Which code would you recommend?

Answer:
Thank you for your inquiry. Without seeing the operative note, and addressing only your question, the correct code is CPT code 27698.

Let’s take a look at the two codes in question:

• 27696 Repair, primary, disrupted ligament, ankle; both collateral ligaments.
• 27698 Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)

The ATFL (anterior talofibular ligament) and the CFL ( calcaneofibular ligament) are ligaments of the lateral complex in the ankle.

CPT code 27698 describes the secondary repair (or reconstruction) of the “collateral” ligament of the ankle, while CPT code 27696 describes a primary repair of both the medial and lateral ligaments in the ankle.

CPT Assistant has advised that a secondary repair code can be used is multiple circumstances, including for chronic injuries and when another tissue is used to perform the repair (reconstruction). A reconstruction would not be performed if the ligament was repairable.

*This response is based on the best information available as of 09/30/21.

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