abaer01
Contributor
I have a doctor that had 15736 (Muscle, myocutaneous, or fasciocutaneous flap; upper extremity) deny when billed with 64721 (Neuroplasty and/or transposition; median nerve at carpal tunnel).
The reason for reporting 15736 is to prevent scar tissue formation at the site of the carpal tunnel release and the flap was taken from over the hypothenar muscles of the hand. He documents harvesting of the flap by naming the vascular structure, but occasionally does not document closure of the secondary defect, specifically when billed with carpal tunnel releases.
This same surgeon bills 15736 for similar reasons for Dupuytren's excisions 26123 & 26121 that also deny due to NCCI bundling edits.
Can someone please let me know if billing pedicle flap procedures done during these routine ortho procedures on the hand is or can be substantiated? I'm concerned that this doctor bills these flap codes because he is accustomed to doing so as a plastic surgeon, but they may not be appropriate to report when done during routine ortho procedures.
The reason for reporting 15736 is to prevent scar tissue formation at the site of the carpal tunnel release and the flap was taken from over the hypothenar muscles of the hand. He documents harvesting of the flap by naming the vascular structure, but occasionally does not document closure of the secondary defect, specifically when billed with carpal tunnel releases.
This same surgeon bills 15736 for similar reasons for Dupuytren's excisions 26123 & 26121 that also deny due to NCCI bundling edits.
Can someone please let me know if billing pedicle flap procedures done during these routine ortho procedures on the hand is or can be substantiated? I'm concerned that this doctor bills these flap codes because he is accustomed to doing so as a plastic surgeon, but they may not be appropriate to report when done during routine ortho procedures.
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