Cpt distal biceps repair

Mar 22, 2021 · In our technique, subacromial decompression, distal clavicle resection, biceps tenodesis, and rotator cuff repair are performed using only a single working portal (anterior), leading to lower morbidities with minimal invasiveness (deltoid sparing), a faster recovery, and fewer anatomic structures at risk during and after the procedure.

In chronic cases of distal biceps tear, the formation of large amount of scar tissue may lead to false positive hook test. 9. After repair of the torn distal biceps tendon, Hook test should reveal normal taut distal biceps tendon after four months of surgery. A negative Hook test at this stage indicates a failed or failing repair. 8 possible. It is designed for rehabilitation following surgical repair of distal biceps tendon. Modifications to the protocol may be necessary dependent on location and size of repair, chronicity of tear, age, weight, comorbidities, and concomitant injuries or procedures performed. This evidence-based guideline for The Arthrex FiberTak Biceps implant (K181769) is used for fixation of soft tissue to bone in the shoulder and elbow. Procedures include, but are not limited to: biceps tendon repair …I NTRODUCTION. Rupture of the distal biceps tendon is estimated to be approximately 10% of all biceps brachii ruptures. 1 Sports persons involved in competitive strength training and contact sports are more susceptible to sustain distal tendon biceps injuries. 2 Although nonsurgical management is an option in sedentary patients, the treatment of complete distal biceps ruptures in active ...Undescended testicle repair is surgery to correct testicles that have not dropped down into the correct position in the scrotum. Undescended testicle repair is surgery to correct t...

With proper and detailed fl exposure, chronic distal biceps injuries can be reconstructed safely and efcaciously using an Achilles allograft. fi. istal biceps ruptures are uncommon events, with an annual incidence of 1.2 complete ruptures per. D 100,000 persons.1 The mechanism of injury typically occurs in the setting of an overwhelming ...Best answers. 0. Jan 23, 2020. #1. Patient having repair of distal biceps tendon rupture, CPT 24342. Wondering if I need to code the Tenodesis Brachialis separately? After biceps was repair, doctor mentions he did Bio-Tenodesis with 1 Vicryl in medial and lateral aspect of biceps and the brachialis to make sure to keep it real medial and real ...The lacertus fibrosus originates at the level of the musculotendinous junction and consists of three distinct layers, enveloping the forearm flexors and serving as a stabilizer to the distal biceps tendon. 6 A tense lacertus fibrosus secondary to contraction of the forearm flexors may contribute to tendon rupture due to a medial pull at the time of …During a distal biceps repair your doctor reattaches the torn biceps tendon to the radius, which is one of the bones in the lower arm. If there is a delay in getting surgery, your …Need to know roof repair costs for common types of repairs? Click here for a complete breakdown, as well as some things to look out for in the repair process. Expert Advice On Impr...Introduction. Subpectoral biceps tenodesis using cortical buttons and the tension slide technique allows the surgeon to tension and repair the long head of the biceps in either a bicortical or unicortical repair. Bicortical. The bicortical technique utilizes the BicepsButton to draw the tendon against the distal cortex of the bone socket.Distal Biceps Repair . Clinic Practice Guideline . Background . Distal biceps tendon ruptures occur primarily in males and risk factors include smoking, corticosteroid use, and anabolic steroid use. Tears occur secondary to unexpected extension forces and are typically associated with a "pop".We would like to show you a description here but the site won’t allow us.

What does "maintenance free" mean on your car battery? Does it mean that you have to discard it if it goes dead? No. It simply means that you do not need to add water to it on a re...Aug 8, 2023 · All distal biceps tendon repairs from 2008 to 2020 were retrieved by CPT code 23432. Their charts were screened for repair method and duration of follow-up. All of the charts were reviewed, and the patients were called or examined in person. Daniel Bubnis is a nationally certified personal trainer who works independently in the Scranton, Pennsylvania area. His specialties include exercise science, health promotion, wel...tendon repair. endobutton. B efore 1961, the recommended treatment for distal biceps ruptures was conservative care. Aside from suturing or attaching tendons through bony drill holes, there was no satisfactory, reliable technique to repair ruptures and, in general, patients regained motion and functional use of their arm.The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique. During the procedure: You will be administered general anesthesia. A small incision is made at the elbow, and the torn or ruptured end of the biceps located. Any damaged tissues are removed using ...Chronic distal biceps tendon ruptures present a unique surgical challenge due to tendon retraction and shortening as well as muscle atrophy. Several graft choices and fixation methods have been described, with no one technique proving superior to date. We describe a technique wherein a tibialis anterior tendon allograft is Pulver-Taft …

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Repair of a distal biceps tendon rupture is a challenging procedure with no consensus as to which technique should be used . The purpose of this study is to evaluate the clinical results of seven consecutive patients who underwent an intra-osseous distal biceps tendon repair using Mitek anchors (DePuy Mitek inc. Warsaw, USA). ...This implant and technique allow tensioning and repair of the biceps tendon through a single anterior incision. The combination of the cortical button fixation coupled with an interference screw creates a strong, anatomic repair.Sheldon-Hall syndrome, also known as distal arthrogryposis type 2B, is a disorder characterized by joint deformities (contractures) that restrict movement in the hands and feet. Ex...CPT® coding is 25609 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments. The arthroscopic attempt at reduction and synovectomy for visualization is included in the open completion of that procedure, as indicated by V64.43, which also is reported. 2.Distal biceps tendon rupture is commonly repaired via bicortical drilling, extramedullary cortical button placement, and inlay tendon fixation. A retensionable technique with unicortical drilling, intramedullary knotless all-suture anchors placement, and onlay tendon fixation is presented, incorporating up-to-date advances in tendon-bone …Apr 16, 2023 · Overall complications of distal biceps tendon repair are in the range of 16-18% with lateral antebrachial cutaneous nerve injury being the most common 2. Other complications of biceps tendon repair are partially related to the surgical approach and include the following 1,2 : posterior interosseous nerve injury. superficial radial nerve injury.

of all venous bleeders. Meticulous care was used to protect the neurovascular structures. After dissecting the fossa, it was readily apparent that this was a myotendinous rupture of the biceps with significant retraction of the muscle belly proximally. The tendon itself after exploration clearly.Repair involves surgical reattachment of the distal biceps tendon to the radius bone at the radial tuberosity, where the tendon naturally inserts into the bone. Surgery is typically performed through a single incision in the front of the elbow or two-incision approach, in which a small second incision is made at the back of the elbow.Distal Biceps Repair Using the BicepsButton™ Implant and Tension-Slide Technique This implant and technique allow tensioning and repair of the biceps tendon through a single anterior incision. The combination of the cortical button fixation coupled with an interference screw creates a strong, anatomic repair. Surgical TechniqueJan 18, 2023 · Video 1. Revision distal biceps repair using the original intramedullary unicortical buttons. The patient is supine on a gurney with a hand table extension. The previous incision is used, and the repair site is exposed. Previously tied knots are carefully undone, and the whipstitch in the distal biceps tendon is taken down, with care taken to ... Jun 14, 2016 · The distal biceps tendon complex may be injured at the musculotendinous junction, by a disruption of the tendon itself “in continuity” or a complete or partial tear or avulsion of the tendon from the radial tuberosity . By far, the most common lesion is the avulsion from the tuberosity, and this is the only lesion that is dealt with in this ... How to Repair Hardwood Floors - You'll need a few special tools and tips to repair your hardwood floors, but otherwise it's a snap when following our simple, step-by-step guide. Ad...Medical Coding. Outpatient Facilities . Wiki distal bicep tendon repair. Thread starter ... . Wiki distal bicep tendon repair. Thread starter trose45116; Start date Sep 17, 2008; Create Wiki T. trose45116 Expert. Messages 313 Location Zephyrhills, FL Best answers 0. Sep 17, 2008 #1 need some help....would 23430 work . M. mbort True … Distal Biceps Rupture Anatomy. Typically avulses from its radial tuberosity insertion. +/- rupture of bicipital aponeurosis. The distal biceps tendon runs in a sheath lateral to the median nerve and brachial artery and medial to the ulnar nerve. Distal biceps tendon has two distinct heads: a continuation of the long head and of the short head. Purpose: To assess the effect of surgical repair for acute distal avulsion injuries of the biceps femoris tendon on (1) return to preinjury level of sporting function and (2) time to return to preinjury level of sporting function, patient satisfaction, and complications. Study design: Case series; Level of evidence, 4. Our Research and Education in Distal Biceps Tendon Rupture. Learn more about our research and professional education opportunities. We can help you find a doctor. Call 646-929-7800 or. NYU Langone’s highly trained orthopedic surgeons are experts at performing repair procedures for a distal biceps tendon rupture. Learn more.

The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique. During the procedure: You will be administered general anesthesia. A small incision is made at the elbow, and the torn or ruptured end of the biceps located. Any damaged tissues are removed using ...

The ACS NSQIP database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017, using Current Procedural Terminology (CPT) code 24342. Cases with concurrent procedures, as determined by concurrent reported CPT codes, were excluded from the final analysis.May 15, 2023 · Complete rupture of the distal biceps tendon is routinely treated with direct repair; however, chronic, mid-substance, or musculotendinous tears are challenging clinical scenarios for surgeons. Although attempts at direct repair should be considered, in cases of severe retraction or tendon deficiency, a reconstruction may be warranted. Herein the authors describe a technique for distal biceps ... Files related to Reinsertion of ruptured biceps tendon, distal, with or without tendon graft (includes obtaining graft) (24342) Find Window. X. Type in text to find: Hand Surgery CPT Codes, sorted by number. Tendon / Muscle Repair CPT Codes - Proximal to hand. American.You've gone through Windows and Mac maintenance, but what about Linux users? I'm pretty new to Linux, and I'm familiar with Windows maintenance, but don't know if ...In the largest study to date for distal biceps femoris avulsion repairs (n = 4), Ahearn and Wood 1 reported a mean return to sport of 5 months. In our study, we observed earlier return to sport in elite athletes at 16.7 ± 8.7 weeks (3.8 ± 2.0 months) after surgical repair of the distal biceps femoris. This may be multifactorial.Oct 5, 2010 · Oct 5, 2010. #2. 27385 Suture of Quadriceps or hamstring muscle rupture; primary procedure. The long head of the biceps femoris makes the Hamstring . So the biceps femoris can be coded for hamstring. Also note the code holds good for quadriceps also. This is a primary repair ( Suture) too. But if yu can give info about what was the actual ... Which code would be more appropriate for a distal biceps rupture repair using Endobutton and FiberWire technique? I like 24342 for this, my co-worker likes 24340. The description in Coding Companion for 24340 fits well but it is a "separate procedure" which is the main reason I like 24342 instead.

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Nov 30, 2021 · Contraindications of distal biceps tendon reconstruction include distal biceps tendon injuries that are amenable to repair and comorbidities increasing the general surgical risk. Procedure Distal biceps tendon reconstruction can be performed utilizing an autograft (e.g. semitendinosus tendon, tensor fasciae latae , palmaris longus , flexor ... We would like to show you a description here but the site won’t allow us.Our Research and Education in Distal Biceps Tendon Rupture. Learn more about our research and professional education opportunities. We can help you find a doctor. Call 646-929-7800 or. browse our specialists. NYU Langone orthopedic surgeons are experts at performing the latest reconstruction procedures for a distal biceps tendon rupture.Distal Biceps Rupture Anatomy. Typically avulses from its radial tuberosity insertion. +/- rupture of bicipital aponeurosis. The distal biceps tendon runs in a sheath lateral to the median nerve and brachial artery and medial to the ulnar nerve. Distal biceps tendon has two distinct heads: a continuation of the long head and of the short head.Oct 5, 2010. #2. 27385 Suture of Quadriceps or hamstring muscle rupture; primary procedure. The long head of the biceps femoris makes the Hamstring . So the biceps femoris can be coded for hamstring. Also note the code holds good for quadriceps also. This is a primary repair ( Suture) too. But if yu can give info about what was the actual ...For questions on reimbursement or to find information for a specific product, please contact the Arthrex Coding and Reimbursement Hotline at 1-844-604-6359 or email us at [email protected]. Coding Guides (30) Achilles Soft-Tissue Implants - 2024 Coding and Reimbursement Guidelines. File Type:Ruptures of the distal biceps brachii tendon are uncommon, constituting only 2% to 10% of all biceps tendon injuries.1 The incidence of this injury is less than 2:100,000 in the general population.2 Distal tendon ruptures occur most commonly in the dominant upper extremity of males between the ages of 40 and 60 years.3 Ruptures typically occur ...The distal biceps tendon attaches the biceps muscle to the bone at the elbow. A distal biceps repair is a procedure to either repair the existing tendon, or to completely reconstruct a replacement tendon. Time is of the essence when repairing a distal biceps tendon – if the biceps tear (also known as a 'rupture') occurred more than 21 days ...CPT codes 29824 (arthroscopic claviculectomy including distal articular surface), 29827 (arthroscopic rotator cuff repair), and 29828 (biceps tenodesis) may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder.Rupture of the distal biceps results in significant losses to flexion and supination strength at the elbow if left untreated, whereas surgical repair of the tendon can restore these strength parameters and is routinely advocated for young and active patients. 6, 10 Various methods of distal biceps repair have been the subject of extensive … ….

Aug 8, 2023 · All distal biceps tendon repairs from 2008 to 2020 were retrieved by CPT code 23432. Their charts were screened for repair method and duration of follow-up. All of the charts were reviewed, and the patients were called or examined in person. tendon repair. endobutton. B efore 1961, the recommended treatment for distal biceps ruptures was conservative care. Aside from suturing or attaching tendons through bony drill holes, there was no satisfactory, reliable technique to repair ruptures and, in general, patients regained motion and functional use of their arm.Approximate Synonyms. Left biceps strain; Left biceps tendon tear; Left distal biceps tendon tear; ICD-10-CM S46.212A is grouped within Diagnostic Related Group(s) (MS-DRG v 41.0):. 562 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with mcc; 563 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh …Video 1 This is a repair of a chronic distal biceps injury in a 53-year-old man with tendon retraction of 7 cm shown on magnetic resonance imaging. He is supine, with the arm over a hand table. Our technique for reconstruction of chronic distal biceps injuries uses an Achilles allograft through a modified Henry approach.possible. It is designed for rehabilitation following surgical repair of distal biceps tendon. Modifications to the protocol may be necessary depending on the location and size of the repair, chronicity of tear, age, weight, comorbidities, and concomitant injuries or procedures performed. This evidence-based guidelineThe lower biceps tendon is called the distal biceps tendon. The word distal means that the tendon is further down the arm. The upper two tendons of the biceps are called the proximal biceps tendons, because they are closer to the top of the arm. The distal biceps tendon attaches to a small bump on the radius bone of the forearm. This ICD-10-CM Diagnosis Code S46.122A [convert to ICD-9-CM] Laceration of muscle, fascia and tendon of long head of biceps, left arm, initial encounter. Laceration of musc/fasc/tend long hd bicep, left arm, init; Left long head of biceps muscle laceration; Left long head of bicepstendon laceration. ICD-10-CM Diagnosis Code S46.20. Distal Biceps Repair | ORTH03.13B | A/Prof Andrew Bucknill – Head of Unit, Department of Orthopaedic Surgery | Last updated June 2021 2 Phase 1: Immediate Postoperative Period (week 1 and 2) Goals • Protect the tendon repair • Control pain and swelling • Maintain range of motion at the shoulder, wrist and elbow Sling (6 weeks) Cpt distal biceps repair, All distal biceps tendon repairs from 2008 to 2020 were retrieved by CPT code 23432. Their charts were screened for repair method and duration of follow-up. All of the charts were reviewed, and the patients were called or examined in person., 3801 Wake Forest Rd, Ste 220, Raleigh, NC 27609. 5.00. 3 verified reviews. 13 years of experience. Aetna, BlueCross BlueShield, Cigna. see more. Dr. Johnny T. Nelson is a Raleigh native and a second-generation orthopedic surgeon. He graduated magna cum laude and phi beta kappa from the University of Dallas, where he played …, Patients who underwent revision distal biceps tendon repair were identified by the second instance of a claim containing CPT-24342. Statistical Analysis Statistical analysis was performed using R statistical software (Version 4.1.0; R Project for Statistical Computing, Vienna, Austria) integrated within the PearlDiver software with an α level ..., Jun 14, 2016 · The distal biceps tendon complex may be injured at the musculotendinous junction, by a disruption of the tendon itself “in continuity” or a complete or partial tear or avulsion of the tendon from the radial tuberosity . By far, the most common lesion is the avulsion from the tuberosity, and this is the only lesion that is dealt with in this ... , 24340: Tenodesis is the suturing of the end of a tendon to a bone; and this code is specifying the suturing of the biceps tendon at the elbow. (separate procedure) 24341: Is a broader code- the repair of a tendon OR muscle (excluding the rotator cuff) 24342: Specifies the reinsertion of ruptured biceps or triceps tendon., The procedure is performed through a 5-cm transverse skin incision, and the tendon is sutured to the Endobutton with 2 number 5 Ethibond sutures. ... This technique is a safe and effective method of repair of distal biceps tendon avulsion that allows active mobilization with minimal risk of complication. (J Shoulder Elbow Surg 2000;9:120-6.), CPT® 23430, Under Repair, Revision, and/or Reconstruction Procedures on the Shoulder. The Current Procedural Terminology (CPT®) code 23430 as maintained by American Medical Association, is a medical procedural code under the range – Repair, Revision, and/or Reconstruction Procedures on the Shoulder. What is a biceps tendon …, %PDF-1.4 %âãÏÓ 279 0 obj > endobj xref 279 45 0000000016 00000 n 0000001701 00000 n 0000001860 00000 n 0000002954 00000 n 0000003395 00000 n 0000003902 00000 n 0000004073 00000 n 0000004187 00000 n 0000004438 00000 n 0000004935 00000 n 0000005192 00000 n 0000005716 00000 n 0000006941 00000 n 0000007252 00000 n …, Treatment for a complete rupture of the distal biceps is usually surgical repair. Without surgery, patients can have less elbow bending strength and forearm rotation strength. …, Summary of Guideline. Dr. Jones and Cvetanovich. Patient to be immobilized in 90 degrees flexion with forearm supinated for 2 weeks post-op. After 2 weeks until 5-6 weeks, …, This procedure releases the pressure of the biceps attachment on the cartilage rim of the labrum (shoulder socket) and allows a portion of the biceps tendon to be surgically removed. Essentially this procedure is moving the attachment of the biceps tendon to a position that is out of the way of the shoulder joint (Cluett 2012). ACHI Code:, Biceps Tendon Repair. The biceps muscle, located in the front of the upper arm, allows bending of the elbow and rotation of the arm. Biceps tendons attach the biceps muscle to the bones in the shoulder and in the elbow. Biceps tears can be complete or partial. Partial biceps tendon tears will not completely break the tendon., As part of the distal biceps repair procedure, the tension-slide technique with the BicepsButton™ implant provides a simple, reproducible, and biomechanically stable repair. This tensioning technique reliably draws the tendon against the distal cortex of the bone socket. Adding a tenodesis screw improves the biomechanical strength and …, Distal Biceps Repair. General Guidelines/Precautions: • Elbow bracing x 6 weeks or per physician • Early limitations in elbow extension passive range of motion (dependent on surgeon and operative procedure) • Avoid active elbow flexion and supination during the acute phase of rehab, May 15, 2023 · Complete rupture of the distal biceps tendon is routinely treated with direct repair; however, chronic, mid-substance, or musculotendinous tears are challenging clinical scenarios for surgeons. Although attempts at direct repair should be considered, in cases of severe retraction or tendon deficiency, a reconstruction may be warranted. Herein the authors describe a technique for distal biceps ... , The distal biceps tendon attaches the biceps muscle to the bone at the elbow. A distal biceps repair is a procedure to either repair the existing tendon, or to completely reconstruct a replacement tendon. Time is of the essence when repairing a distal biceps tendon – if the biceps tear (also known as a 'rupture') occurred more than 21 days ..., A distal biceps rupture off the radial tuberosity often presents with painful swollen elbow and significant loss of strength in rotation and flexion. Distal biceps tendon repair using the BicepsButton™ and tension-slide technique allows the surgeon to tension and repair the biceps tendon through a single anterior incision., Complete rupture of the distal biceps brachii accounts for approximately 3% of all biceps ruptures (the long head ruptures account for 96% and the short head 1%). 1 The loss of function from a distal biceps tendon rupture is substantial secondary to the total loss of torque produced by the biceps brachii resulting in decreased strength in elbow ..., CPT codes 29824 (Arthroscopic claviculectomy including distal articular surface), 29827 (Arthroscopic rotator cuff repair), and 29828 (Biceps tenodesis) may be reported separately with CPT code 29823 if the extensive debridement is performed in a different area of the same shoulder., Distal Biceps Repair | ORTH03.13B | A/Prof Andrew Bucknill – Head of Unit, Department of Orthopaedic Surgery | Last updated June 2021 2 Phase 1: Immediate Postoperative Period (week 1 and 2) Goals • Protect the tendon repair • Control pain and swelling • Maintain range of motion at the shoulder, wrist and elbow Sling (6 weeks), Distal biceps tendon ruptures typically require surgical fixation to restore range of motion and strength to the elbow. This procedure is an open surgical procedure which can be performed on an outpatient basis. The goal is to reattach the tendon to the radius bone using either sutures or anchor with sutures. Proximal biceps tendon …, Tears of the distal biceps are common, and nonoperative treatment results in significant loss of supination strength. Surgery is indicated for most patients to restore this supination strength. Both 1- and 2-incision techniques are successful, but each has its own advantages and disadvantages. We believe the 2-incision technique better restores the anatomic attachment site of the tendon, which ... , CPT ® 25405, Under Repair, Revision, and/or Reconstruction Procedures on the Forearm and Wrist The Current Procedural Terminology (CPT ® ) code 25405 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Forearm and Wrist., CPT: Get the latest Camden Property Trust stock price and detailed information including CPT news, historical charts and realtime prices. Some REITs (real estate investment trusts)..., In the largest study to date for distal biceps femoris avulsion repairs (n = 4), Ahearn and Wood 1 reported a mean return to sport of 5 months. In our study, we observed earlier return to sport in elite athletes at 16.7 ± 8.7 weeks (3.8 ± 2.0 months) after surgical repair of the distal biceps femoris. This may be multifactorial., Answer: You can use 24342 (Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft ). This code specifies the reinsertion of ruptured biceps or triceps, distal end. Orthopedic surgeons always repair triceps distally. Another code possibility is 24341 (Repair, tendon or muscle, upper arm or elbow, each tendon or ..., If you perform several procedures in one surgical setting, example – arthroscopic rotator cuff repair, acromioplasty, distal clavicle resection and biceps tenodesis. This procedure would be coded: Arthroscopic rotator cuff repair – 29827. Arthroscopic biceps tenodesis – 29828, 59 modifier. Arthroscopic distal clavicle resection – 29824 ..., Bain et al recently reported the use of the Endobutton for repair of the tendon. This procedure allows for a relatively minimal single anterior incision to reattach the tendon without struggling in a small space. This is a report of our use of the Endobutton in 11 patients who suffered rupture of the distal biceps tendon., Our Research and Education in Distal Biceps Tendon Rupture. Learn more about our research and professional education opportunities. We can help you find a doctor. Call 646-929-7800 or. NYU Langone’s highly trained orthopedic surgeons are experts at performing repair procedures for a distal biceps tendon rupture. Learn more., It’s easy to exercise the muscles you can see—your biceps, your quads—but there are more muscles in your body than just the big ones. We’ve talked before about the muscles in your ..., Overall complications of distal biceps tendon repair are in the range of 16-18% with lateral antebrachial cutaneous nerve injury being the most common 2. Other complications of biceps tendon repair are partially related to the surgical approach and include the following 1,2 : posterior interosseous nerve injury. superficial radial nerve injury., The ACS NSQIP database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017, using Current Procedural Terminology (CPT) code 24342. Cases with concurrent procedures, as determined by concurrent reported CPT codes, were excluded from the final analysis., As far as coding, there is no separate code for this in this case. There is for an Achilles tendon tear, but not of the biceps tendon. You will need to use modifier -22 for the additional time & skill involved with the repair, but the physician needs to do their part by including the additional work and the reason for it in the op note.