# hypertrophic burn scar excision with VYS plsaty rearrangement



## ms123 (Apr 6, 2010)

I have a patient who is status post a severe burn and has hypertrophic scar. They are doing an excision of the scar with a double opposing V-Y-S plasty, fasciocutaneous rearrangement/reconstruction on the hand. The area is about 35 sq. cm after excision of scar. Tnesion-free closure accomplished. I was going to use 14301 with Dx code of 701.4. Does this totally cover this procedure and are there any supporting references available on this to verify?

Thank you so much for any help!


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## FTessaBartels (Apr 6, 2010)

*Can you post op note?*

It would be best to have the op note, but the short answer is Yes ..  
Per Encoder Pro, the description is: 
The physician transfers or rearranges adjacent tissue of any area to repair traumatic or surgical wounds. This includes, but is not limited to, such rearrangement procedures as Z-plasty, W-plasty, ZY-plasty, or tissue transfers such as rotational flaps or advancement flaps. Report 14301 for defects 30.1 sq cm to 60 sq cm. Report 14302 for each additional 30 sq cm or part thereof. 

The CPT guidelines further tell us that excision of the lesion (or scar in this case) is included in the tissue transfer codes. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## ms123 (Apr 7, 2010)

*thanks*

Thank you so much for your reply. Here is what the op report says - it does not go into any kind of detail:

Anesthesia was introduced of the median, ulnar and radial nerves utilizing 1% plain lidocaine accordingly.  Right hand hypertrophic scar excision with double opposing V-Y-S-plasty, fasciocutaneous rearrangement with elevation of hte subfascial plane and rearrangement in a tension-free fashion. The surface area that was covered was approximately 35 cm2, 7 x 5 cm surface area dimension after the excision of the scar. Tension-free closure was accomplished. The estimated blood loss was approximately 10-15 cc. Satisfactory reconstruction was observed. 


It's actually just a statement of what was done and no actual details. Hopefully this helps. Thanks again.


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