Wiki Z-Plasty after MOHS for scar

[Texascoder64]

MOHS coders out there - need to know if Z-plasty for reconstruction of scar on cheek post MOHS (approx. 4-6 months post mohs ).
If the hypertrophic scar icd-9 will cause a denial for cosmetic with insurance?

Any advise on this topic is greatly appreciated.

 

[FTessaBartels]

Depends

Much will depend on the patient's insurance carrier and the diagnosis coding.

You'll probably want to include an aftereffect code in addition to the hypertrophic scar.

Be prepared to request peer-to-peer review BEFORE getting approval.

We never schedule surgery until we have the prior authorization to proceed (or payment in advance from patients for whom procedures have been deemed cosmetic).

Hope that helps.

F Tessa Bartels, CPC, CEMC