nlbarnes
Expert
Hello - I have to procedure notes.
The guidelines in Encoder for 14040 excludes complex closure. Complex closure wounds by undermining surrounding tissue without additional incisions (13100-13160). Undermining is part of the adj tissue tx so that's confusing me.
I'm not sure if it would apply to this procedure. I realize that I will need to have the provider add the size of the repair.
Procedure note 1) 14040 & 1313X?
The patient was prepped and draped in the usual sterile fashion. 1% lidocaine with epinephrine at 1 100,000 dilution was injected around the 1.8 x 1.4 cm full-thickness skin defect in the right mid forehead.
Adequate analgesia was confirmed. An O-L rotation advancement flap was marked out on the patient's forehead. 15 blade was used to make the incision. A Burow's triangle was removed from the superior limb. Wide undermining was performed. Total area of the tissue advanced was 1.5 x 3.5 cm. This was sutured in 3 layers with 4-0 Vicryl deep sutures 4-0 Vicryl deep dermal sutures and 4-0 chromic sutures for skin.
Can I submit 14040 & 1313X?
Procedure note 2) 14040, 15004 & 1313X? I don't think the closure is allowed here.
A 1.3 cm diameter circular full-thickness wound of the forehead just inferior to the hairline was noted. 1% lidocaine with epinephrine at 1 100,000 dilution was injected around this wound. Debridement commenced. 15 blade and curved iris scissors were used to trim away any necrotic debris. Areas of prior cautery was also trimmed away. A limited amount of bipolar cautery was used for hemostasis.
An O- T rotation advancement flap was marked out of the skin. Total area advanced was 2.5 x 2.5 cm. A Burow's triangle at the base of the wound was removed. The skin was widely undermined and lifted on either side. Advancement from lateral to medial was performed. The flaps were approximated in the midline with multiple 4-0 Vicryl interrupted sutures at both the deep and deep dermal layers. Once the flaps had been advanced and sutured together the skin was closed with 4-0 chromic interrupted sutures. Mastisol bacitracin Telfa and Steri-Strips were used as a dressing.
Thank you...
The guidelines in Encoder for 14040 excludes complex closure. Complex closure wounds by undermining surrounding tissue without additional incisions (13100-13160). Undermining is part of the adj tissue tx so that's confusing me.
I'm not sure if it would apply to this procedure. I realize that I will need to have the provider add the size of the repair.
Procedure note 1) 14040 & 1313X?
The patient was prepped and draped in the usual sterile fashion. 1% lidocaine with epinephrine at 1 100,000 dilution was injected around the 1.8 x 1.4 cm full-thickness skin defect in the right mid forehead.
Adequate analgesia was confirmed. An O-L rotation advancement flap was marked out on the patient's forehead. 15 blade was used to make the incision. A Burow's triangle was removed from the superior limb. Wide undermining was performed. Total area of the tissue advanced was 1.5 x 3.5 cm. This was sutured in 3 layers with 4-0 Vicryl deep sutures 4-0 Vicryl deep dermal sutures and 4-0 chromic sutures for skin.
Can I submit 14040 & 1313X?
Procedure note 2) 14040, 15004 & 1313X? I don't think the closure is allowed here.
A 1.3 cm diameter circular full-thickness wound of the forehead just inferior to the hairline was noted. 1% lidocaine with epinephrine at 1 100,000 dilution was injected around this wound. Debridement commenced. 15 blade and curved iris scissors were used to trim away any necrotic debris. Areas of prior cautery was also trimmed away. A limited amount of bipolar cautery was used for hemostasis.
An O- T rotation advancement flap was marked out of the skin. Total area advanced was 2.5 x 2.5 cm. A Burow's triangle at the base of the wound was removed. The skin was widely undermined and lifted on either side. Advancement from lateral to medial was performed. The flaps were approximated in the midline with multiple 4-0 Vicryl interrupted sutures at both the deep and deep dermal layers. Once the flaps had been advanced and sutured together the skin was closed with 4-0 chromic interrupted sutures. Mastisol bacitracin Telfa and Steri-Strips were used as a dressing.
Thank you...
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