Good Evening, Well, there is no CCI edit, can I presume there was excess tissue due to body habitus? Listen, you can only try, right! Based on everything I have researched there is no reason that you cannot bill these two procedures together. With limited info, performing a trach with fenestrated flaps indicates this individual needs a permanent trach, possibly due to body habitus and if removing excess skin provides a better outcome than there is no reason not to bill this, it is medically necessary. Documentation should support medical necessity and state that is was not for cosmetic reasons.
Jennifer
Coding Analyst