april.josey
New
Help! Traditionally, when the surgeon I work for performs a lumpectomy, we bill for an adjacent tissue transfer flap closure (14001-14301) as well because he creates flaps via new incisions to mobilize the tissue.
He mentioned that the procedure more closely mirrors a fasciocutaneous flap (15734). We are wondering what the correct coding would be. Here is a sample of a report:
".... the skin was excised in a crescent shaped manner to allow for fasiocutanious flap closure. Skin flaps were developed cranially and caudally. The breast was then resected down to the chest wall encompassing a malignancy. Following resection of the specimen it was oriented on cardboard and sent to pathology. The defect measured 8X5cm. The breast flaps were then created by making an incision in teh pectoral fascia and mobilizing the fascia off the pectoral muscle. This was accomplished for 5-6 cm circumferentially. Following developing adequate mobility in the breast fasciocutaneous flapsthe breast was reconstructed. The deep fascial flaps were reapproximated with 2-0 vicryl. More superficial flaps were approximated with 2-0 vicryl. SubQ tissue was closed with 3-0 vicryl and skin was closed with 4-0 vicryl."
He mentioned that the procedure more closely mirrors a fasciocutaneous flap (15734). We are wondering what the correct coding would be. Here is a sample of a report:
".... the skin was excised in a crescent shaped manner to allow for fasiocutanious flap closure. Skin flaps were developed cranially and caudally. The breast was then resected down to the chest wall encompassing a malignancy. Following resection of the specimen it was oriented on cardboard and sent to pathology. The defect measured 8X5cm. The breast flaps were then created by making an incision in teh pectoral fascia and mobilizing the fascia off the pectoral muscle. This was accomplished for 5-6 cm circumferentially. Following developing adequate mobility in the breast fasciocutaneous flapsthe breast was reconstructed. The deep fascial flaps were reapproximated with 2-0 vicryl. More superficial flaps were approximated with 2-0 vicryl. SubQ tissue was closed with 3-0 vicryl and skin was closed with 4-0 vicryl."