# Advancement flaps



## Bernice929 (Nov 19, 2013)

I need some opinions regarding advancement flaps.  I have a surgeon who is closing a hernia with an advancement flap she says but how much documentation would she need to bill for the flap?  She completed a ventral hernia repair putting mesh in and this patient was allergic to many suture types. Here is her exact words:

*Subdermal layer was closed with 3-0 Vicryl in order to do this advancement flaps were made laterally to loosen the skin, bleeding had been controlled with electrocautery. Skin was then closed with staples. *

I do not feel this is enough documentation to bill for an advancement flap. 

Opinions????


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## capricew (Nov 19, 2013)

Bernice929 said:


> I need some opinions regarding advancement flaps.  I have a surgeon who is closing a hernia with an advancement flap she says but how much documentation would she need to bill for the flap?  She completed a ventral hernia repair putting mesh in and this patient was allergic to many suture types. Here is her exact words:
> 
> *Subdermal layer was closed with 3-0 Vicryl in order to do this advancement flaps were made laterally to loosen the skin, bleeding had been controlled with electrocautery. Skin was then closed with staples. *
> 
> ...



I believe you would be able to bill your hernia repair code 46952 as well as code 14000 as long as she documented the size of the defect before closure.  14000 fits because she had to make additional incisions to do the advancement flap and the work was more than just undermining tissue to achieve closure.

Good Luck!


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