# Flap Reconstruction



## medcode (Jul 8, 2008)

I am asking for help with the correct CPT codes for this bilobed flap repair, I have not encounter one and want to make sure I am corect.

I have pasted the OP report.

PREOPERATIVE DIAGNOSIS:  Right alar defect secondary to Mohs excision of basal cell carcinoma. 

PROCEDURE:  Bilobe rotation flap for reconstruction of right alar defect. 

ANESTHESIA:  General oral endotracheal. 

COMPLICATIONS:  None. 

ESTIMATED BLOOD LOSS:  20 mL. 

STATUS TO THE PACU:  Excellent. 

OPERATIVE REPORT:  The patient was brought to the operating room and a general oral endotracheal anesthesia administered after he was identified.  The patient's face was then prepped and draped for reconstructive surgery.  There was a large defect of the right ala secondary to Mohs surgery 2 days prior to this operation.  It was noted that there was a small focus of through and through perforation from the Mohs surgery and this was closed on the subcutaneous side with interrupted sutures of 5-0 chromic.  At this point, a bilobe flap was created with the major lobe being approximately 2 cm in diameter and the secondary lobe being 1 cm in diameter.  The lobes were outlined, undermined and then advanced into the defect and 5-0 Vicryl was used for subcutaneous closure.  The skin was closed with interrupted sutures of 6-0 nylon.  The pressure dressing was applied after closure.  At the time of closure, there was no evidence of any tension of the wound or flap and there did not appear to be any elevation of the commissure of the lip of the right side or depression of the lower lid on the right side producing any ectropion.  The pressure dressing was applied and the patient was awakened and returned to the PACU in excellent condition. 

Thanks in advanced for all help.


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