# advancement flap



## jocoffey (Apr 8, 2016)

Hi,  please read the following documentation-md is trying to bill for a partial glossectomy(41120) and adjacent tissue rearrangement for closure of defect(14061)

  The pt. was taken to operating room, placed asleep by Anesthesia.  The area was prepped and draped in the usual sterile fashion. Biopsy was taken
   showed squamous cell carcinoma. Therefore a 6mm margin was marked as well as a 6mm deep margin of muscle.  The specimen was removed en 
   bloc and sent for permanent pathology.   The area was then closed primarily using 3-0 vicryl sutures and ultimately 3-0 vertical mattress sutures
   after undermining was performed to create a 3x4 advancement flap to close the defect on the tongue.  This was closed using horizontal mattress
   3-0 vicryl sutures.

   Reading this documentation, is this enough documentation to support billing for the advancement flap along with the partial glossectomy?

    We need help?    Thank You


----------



## catprocode (Apr 11, 2016)

*41120 includes closure via sutures*

I do not believe it would be necessary to also code for undermining since 41120 includes closure via suturing. I would try adding a 22 mod and increasing the fee if documentation describes additional time/effort.


Here is description to 41120 I doubt insurance will pay for the flap 

The physician removes less than one half of the tongue in 41120 or one half of the diseased, often malignant, tongue in 41130. The physician makes incisions around the portion of the tongue to be removed and extends the incisions through the thickness of the tongue. Scalpels, scissors, electrocautery, or lasers may be used. The diseased portion is removed. After obtaining good hemostasis (controlled bleeding), the tongue is sutured closed to repair the surgical wound.Tissue grafting to close the wound is rarely needed


----------

