If you don’t know the ins-and-outs of coding cutting edge procedures, you risk getting left in the dust as medicine continues to evolve. A new techniques, however, doesn’t always mean a new, corresponding CPT code. Check out this podiatry Topaz coding example.
What is Topaz: “The TOPAZ MicroDebrider is a tool which utilizes Coblation® technology to perform a small incision in the fascia and is considered an alternative to the use of standard surgical instruments such as scalpels, low frequency electrocautery, and so forth,” according to CPT Assistant, September 2009. This technology enables the physician to “microdebride” soft tissue present within the tendons of the knee, shoulder, elbow, ankle, and foot.
Read on to unravel the mystery surrounding Topaz procedure coding and billing.
Which Code Goes With Topaz Procedures?
Don’t flip through CPT or HCPCS looking for a Topaz code, because there isn’t one.
The TOPAZ MicroDebrider is a tool and not a procedure, says Hoda Henein, CHBME, CPL, president and CEO, Active Management in College Point, NY.
Do this: Select a code based on the actual service the physician performs and which anatomy it involves. CPT Assistant instructs you to do this for procedures involving Topaz and this has also been the position of the American Academy of Orthopaedic Surgeons (AAOS) since April 2006, adds John F. Bishop, PA-C, CPC, president and CEO, Bishop & Associates Inc. in Tampa, Fla.
Example: If your podiatrist uses the Topaz microdebridement wand to complete an Achilles tendon repair, explains Henein, based on the nature of the repair you would select either:
- 27654 — (Repair, secondary, Achilles tendon, with or without graft), or
- 27658 — (Repair, flexor tendon, leg; primary, without graft, each tendon)
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