Otolaryngology Coding Alert

Question: An otolaryngologist performed closure of septal perforation with a pedicled inferior turbinate mucosal flap. He created a hearty flap of the left inferior turbinate, and this flap was carried posteriorly and then used as a seal to help create a contact point between the flap and the perforation. The flap was unrolled and carefully placed with the pedicle still attached onto the septal perforation. Would the code for pedicle flap be 15740 or 15750 or something else?


Florida Subscriber


Answer: You should code repair of nasal septal perforations with 30630 (Repair nasal septal perforations). According to the Coders- Desk Reference, this involves the creation of local mucoperichondrial flaps on either side of the perforation with a scalpel. Each flap is designed to expose one side of the septal cartilage while retaining mucosal coverage of the septal cartilage of the opposite side. The flaps are sutured in a single layer to cover the perforation. This description matches your otolaryngologist's notes.

The codes that you mention describe microvascular flaps: 15740 is an -island pedicle- flap, and 15750 is a -neurovascular pedicle- flap.