by Raymund Janevicius, MD
Enjoy a free coding perspective from the March 2015 PRS article “A Decade of Conflict: Flap Coverage Options and Outcomes in Traumatic War-Related Extremity Reconstruction”
CPT CODING PERSPECTIVE:
15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk
15736 Muscle, myocutaneous, or fasciocutaneous flap; upper extremity
15738 Muscle, myocutaneous, or fasciocutaneous flap; lower extremity
15756 Free muscle or myocutaneous flap with microvascular anastomosis
15757 Free skin flap with microvascular anastomosis
15758 Free fascial flap with microvascular anastomosis
Pedicled muscle, myocutaneous, or fasciocutaneous flaps are reported with the 1573X series, based upon the donor site of the free flap. Thus, a latissimus dorsi flap to the upper extremity is reported with code 15734.
- Free muscle flaps are reported with code 15756. A rectus abdominis free flap to the lower extremity is reported with code 15756.
- Code 15757 is used to report free skin flaps.
- Free flap codes include
- Harvest of the free flap
- Dissection of recipient vessels
- Microvascular anastomosis of one artery and two veins
- Inset of the flap
- Direct closure of the donor site
- Monitoring of the flap intra-operatively and post-operatively
- The flap codes do not include donor site preparation, such as wound excision and excision of non-viable tissue. Use the 1500X series for surgical wound preparation prior to flap transfer
Additional procedures, such as skin grafting of a muscle flap are separately reported.
- A Decade of Conflict: Flap Coverage Options and Outcomes in Traumatic War-Related Extremity Reconstruction
Sabino, Jennifer; Polfer, Elizabeth; Tintle, Scott; More. Plastic & Reconstructive Surgery. 135(3):895-902, March 2015.