Wiki Removal of skin flap?

[robynreynon]

I have never run into this before.. Patient had Mohs on right helix 1/27/16. Repair was done with a flap. Patient comes back in March complaining of persistent pain and irritation, so provider removes the flap. He is emailing me asking how to code a flap takedown. I can't find anything for this.. Any insight?

 

[JesseL]

I've never gone down this route but you could try the 17999 or 69339 unlisted code and paper claim it with operative notes. Wouldn't the patient have a open wound without the flap? Just wondering. Maybe look at 69110? Not sure if that's considered removing piece of an ear.

 

[robynreynon]

This is what the doctor sent me last night:
So what I did is a two stage transpostion flap. The first stage is immediately after the excision and closes the wound but the flap then needs to be revised to cut it from the healed wound site and partially replace it to the donor site. It is not an excision.

So we are leaning towards 15630 with mod 58.. for delay or sectioning of flap..

He really stumped me on this one. I'm still not 100% confident, but it seems like the best answer after he clarified a little more.

 

[thomas7331]

The delay of flap codes 15600-15630 are the correct codes to use for the takedown of the flap, so you are correct with 15630-58 in this situation.