# lip repair after basal cell carcinoma excision



## AnneCline (Dec 29, 2009)

Any help with coding this repair would be appreciated! I was looking at 14060 but not sure if that would be correct or enough.

The 3 cm, full-thickness cutaneous mucosal defect of the left oral commissure involving both the superior and inferior lip was noted and marked. Burrow's triangles were excised superiorly and inferiorly from the mucosal lip along the vermillion border. 
Another burrow's triangle was excised in an oblique fashion lateral to the oral commissure. Subcutaneous and submucosal dissection proceeded circumferentially cutaneously and along the superior and inferior lip preserving orbicularis oris muscle. The oral commissure was then recreated cutaneously and reapproximated with 5-0 Monocryl in simple interrupted fashion. Rolling advancement flaps were then elevated and moved into position from intraoral to extraorally recreating the vermillion border. Multiple additional oblique burrow's triangles were excised to deal with the excess mucosa. #5-0 Monocryl was used intraorally as well to 
reapproximate the complex closure intraorally and extraorally recreating the dry mucosal oral commissure. Bleeding was controlled with direct pressure and 
light electrocautery.


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## FTessaBartels (Jan 6, 2010)

*40525*

I'm not certain (our Pediatric Plastic Surgeons deal mostly with cleft lip repairs) ... 

But did you look at CPT 40525?  Per Encoder Pro, the lay description reads: The physician removes a full thickness portion of the lip with local flap reconstruction. A "V" incision may be made around the lesion and through the full thickness of the lip. The lesion and surrounding tissues are removed. A local skin flap is incised and advanced to the site of the surgical wound and sutured into place with layered closure. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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