CODING PERSPECTIVE: DECADE OF CONFLICT: FLAP COVERAGE OPTIONS AND OUTCOMES IN TRAUMATIC WAR-RELATED EXTREMITY RECONSTRUCTION

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.

For a list of all articles with CPT coding visit the CPT Coding Collection on the Residents’ Gateway Homepage.

REFERENCES
______________________________________________________

  1. 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.
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