Question:
Mpoole714:
Hi,
I am having difficulty differentiating between adjacent tissue transfers and flaps. Could you provide clarification on when you would code one versus the other?
Thank you!
Answer Thread:
Alicia Scott:
http://www.entusa.com/rotation_advancement_20071212.htm Flap
Tissue transfer is when they take tissue from someplace else and cover the wound. A flap is also taking tissue but from close to the woud and it is flopped over the wound.
The vascular system is something that you pay attention to. As I understand it a flap keeps the same vascular system and a tissue transfer does not.
Dolores Soliz:
Thanks for the tip Alicia
Laureen:
Fip Flop ha ha
Luna:
Hi Mpoole714,
I'm with you. It can get confusing. I questioned too, how do you know if you need to code from Adjacent Tissue Transfer or Rearrangement (14000-14350) or Flaps (Skin and/or Deep Tissues) (15570-15738).
I would get confused between something that would maybe be considered a "rearrangement" or a "flap", because flapping a piece of skin this way from that way seemed like a rearrangement to me…and yet it also sounded like a flap...and well, is a flap a transfer or is a flap a flap??? …A flap process sounds very like an adjacent tissue replacement but there are important differences.
One resource (an AAPC textbook) listed 3 things to keep in mind when distinguishing between the two services:
·The base of the pedicle flap is eventually cut or severed from its original blood supply after the skin transfer has been completed. (15570-15738)In an adjacent tissue transfer, the base remains intact permanently. (14000-14350)
·Pedicle flaps are formed on an area distant from the defect where it is being transferred to. (15570-15738) In an adjacent tissue transfer, transfer is made from a local flap. (14000-14350)
·Pedicle flaps are often completed in multiple stages but can be formed and transferred in one stage. (15570-15738) Adjacent tissue transfers are completed in a single stage. (14000-14350)
Understanding the anatomy of the integument also helps. Remember that flap procedures that fall in the 15550-15738 range are going to involve more than the "skin". They are going to include skin and deep tissues- or only deep tissues; muscle, vascular structures and sometimes nerves will all be part of the "flap".
Those are some of the things I keep in mind to help me distinguish what code range I need to be looking at when the procedures sound similar. I still get stumped, and have to Google for pictures, articles and videos to help me visualize the processes involved. But, I thought I'd share those tips with you. They really helped me.
Mpoole714:
Hi,
I am having difficulty differentiating between adjacent tissue transfers and flaps. Could you provide clarification on when you would code one versus the other?
Thank you!
Answer Thread:
Alicia Scott:
http://www.entusa.com/rotation_advancement_20071212.htm Flap
Tissue transfer is when they take tissue from someplace else and cover the wound. A flap is also taking tissue but from close to the woud and it is flopped over the wound.
The vascular system is something that you pay attention to. As I understand it a flap keeps the same vascular system and a tissue transfer does not.
Dolores Soliz:
Thanks for the tip Alicia
Laureen:
Fip Flop ha ha
Luna:
Hi Mpoole714,
I'm with you. It can get confusing. I questioned too, how do you know if you need to code from Adjacent Tissue Transfer or Rearrangement (14000-14350) or Flaps (Skin and/or Deep Tissues) (15570-15738).
I would get confused between something that would maybe be considered a "rearrangement" or a "flap", because flapping a piece of skin this way from that way seemed like a rearrangement to me…and yet it also sounded like a flap...and well, is a flap a transfer or is a flap a flap???
…A flap process sounds very like an adjacent tissue replacement but there are important differences.One resource (an AAPC textbook) listed 3 things to keep in mind when distinguishing between the two services:
·The base of the pedicle flap is eventually cut or severed from its original blood supply after the skin transfer has been completed. (15570-15738)In an adjacent tissue transfer, the base remains intact permanently. (14000-14350)
·Pedicle flaps are formed on an area distant from the defect where it is being transferred to. (15570-15738) In an adjacent tissue transfer, transfer is made from a local flap. (14000-14350)
·Pedicle flaps are often completed in multiple stages but can be formed and transferred in one stage. (15570-15738) Adjacent tissue transfers are completed in a single stage. (14000-14350)
Understanding the anatomy of the integument also helps. Remember that flap procedures that fall in the 15550-15738 range are going to involve more than the "skin". They are going to include skin and deep tissues- or only deep tissues; muscle, vascular structures and sometimes nerves will all be part of the "flap".
Those are some of the things I keep in mind to help me distinguish what code range I need to be looking at when the procedures sound similar. I still get stumped, and have to Google for pictures, articles and videos to help me visualize the processes involved. But, I thought I'd share those tips with you. They really helped me.