by Raymund Janevicius, MD
Enjoy a free coding perspective from the March 2015 PRS article “Microsurgical Scalp Reconstruction in the Elderly: A Systematic Review and Pooled Analysis of the Current Data”
15756 Free muscle or myocutaneous flap with microvascular anastomosis
15757 Free skin flap with microvascular anastomosis
15758 Free fascial flap with microvascular anastomosis
49906 Free omental flap with microvascular anastomosis
- The free flap codes are not donor site specific. All free muscle flaps are reported with code 15756. Thus, a free rectus abdominis flap and a free latissimus dorsi flap are each reported with code 15756.
- Both free muscle and free myocutaneous flaps are reported with code 15757.
- All free skin flaps are coded with CPT code 15757.
- Free flap codes are global and include:
- Harvest of the free flap
- Direct closure of the donor site
- Dissection of recipient vessels
- Microvascular anastomosis of one artery and two veins
- Inset of the flap
- Monitoring of the flap intra-operatively and post-operatively
- If other procedures are performed to reconstruct the scalp defect, they are separately reported. A split thickness skin graft to cover a muscle flap is reported with codes 15120 and 15121, based upon the size of the skin graft.
- The primary ablative procedures are coded separately, in addition to the free flap codes.
Microsurgical Scalp Reconstruction in the Elderly: A Systematic Review and Pooled Analysis of the Current Data
Sosin, Michael M.D.; Schultz, Benjamin D. B.A.; De La Cruz, Carla B.S.; Hammond, Edward R. M.D., M.P.H., Ph.D.; Christy, Michael R. M.D.; Bojovic, Branko M.D.; Rodriguez, Eduardo D. M.D., D.D.S.
Plastic & Reconstructive Surgery: March 2015 – Volume 135 – Issue 3 – p 856–866 doi: 10.1097/PRS.0000000000000959