# Muscle and skin advancement flap wound closure



## DevonaG (Sep 26, 2011)

Can someone help me?  I am trying to code for the above procedure and wondering if I can code for the closure as well as the flap - I'm thinking 15734 but he also does muscle.  This was done for patients' I&D of spinal wound and iliac crest wound - here is what the physician says he did:

At this point the Wound V.A.C was removed and the skin margins were examined.  They wre found to be healthy.  These were trimmed back to good bleeding tissue and this was thoroughly curetted to get a good bleeding bed.  This wound condition ws noted in the midline spinal wound as well as the right iliac crest wound.

Examiniation of the wounds was now undertaken to see if primary closure was possible.  This was felt to certainly be possible given the healthy condition of the wounds themselves.  However, skin advancement flaps would be necessary in order to perform this.  The skin layer was undermined to the posterior axillary line and this allowed the skin to be advanced and primarily closed without undue tension.

Sorry I only code ortho lol - so i'm not sure about the wound closure things but i want to make sure I code for everything for full reimbursement - thanks!


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## FTessaBartels (Oct 4, 2011)

*closure included*

Like most surgeries, closure (of the primary site) is included in the code.

However, look at your guidelines for grafts / flaps.  You may be able to code closure of the DONOR site if applicable  (usually does NOT apply to advancement flaps). 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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