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General Surgery Coding Alert

Reader Question:

Keep Flaps Straight for Proper Code Selection

Published on Fri Feb 26, 2010

Question: Our surgeon performs an abdominal closure using left and right myofascial advancement flaps. I believe we should code one unit of 15734 because flap codes refer to the recipient area -- not donor site. But the surgeon believes we should code 15734 x 2 because he uses two flaps to perform the defect closure. What is the correct coding? Arkansas Subscriber Answer: You should not report 15734 (Muscle, myocutaneous, or fasciocutaneous flap; trunk) for this service -- either once or twice. Instead, you should list the procedure using an adjacent tissue transfer code such as 14000 (Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less) or 14001 (... defect 10.1 sq cm to 30.0 sq cm) depending on the defect size. Here's why: Adjacent tissue transfer rearrangement includes repair by advancement flaps, according to CPT instruction in the introduction to those codes. On the other hand, 15734 does [...]
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