# Bilobed flap recons



## nabernhardt

I am hoping someone has an idea for a CPT code for this procedure please
PREOPERATIVE DIAGNOSIS: Basal cell carcinoma tip of nose.
POSTOPERATIVE DIAGNOSIS: Basal cell carcinoma tip of nose.
FINAL DIAGNOSIS: Basal cell carcinoma tip of nose.
PROCEDURE: Wide local excision 1.5 cm total dimension with bilobed flap reconstruction.
PROCEDURE: The patient was taken to the operative area where his nose was prepped and
draped in the usual fashion, injected with 2% lidocaine and 1:100,000 epinephrine. After an appropriate time period, a circumferential incision around the basal cell carcinoma of the right super tip area was undertaken using a 15 blade followed by sharp and blunt scissors dissection. The edges were undermined. A bilobed flap with the first lobe at 80% of the defect at a 30-40 degree angle and the second lobe at 80% of the donor site at a 90 degree angle to the original lesion. These were elevated using sharp and blunt scissors dissection. Dissection was then used to elevate the skin around the margin. Cautery was used to control bleeding. Deep tissue was closed with a chromic in an everting fashion after appropriate rotation and advancement of the bilobed flaps. Skin was ultimately closed with a 5-0 Prolene in a simple fashion.


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## jtessman

I think should be using adjacent tissue transfer. Use 14060 or 14061 but you will need to clarify with the surgeon the area in cm sq. The lesion removal is included in the tissue transfer.

Thanks,
Jessica Tessman CPC


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## nabernhardt

thank you.  I was kind of thinking that too but since dr had not documented sq cm wasnt sure.


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