Marie Hadock asked:
So I am thinking that for this procedure that code 15600 should be used? and not 19364 since it reads that this patient is coming in for a delayed formal flap?
The procedure is: bilateral formal _**Delayed**_ Procedure for later TRAM musculocutaneous flap reconstruction of breast cancer mastectomy site via incision of lower abdominal wall and suture ligation of bilateral deep inferior epigastric vessels. The lower abdominal planned incision was now incised with a scalpel. The incision was carried down to the fascia with a bovie electrocautery. The superior medial portion over the muscle was beveled the fat attempting to capture more perforators. We then incised the anterior rectus sheath over the medial and lateral portion of the rectus abdominis muscle bilaterally. Inferiorly; the muscles were partially transected with cautery and the DIE artery (Deep inferior epigastric)and veins were doubly ligated with 2-0 silk sutures. The closure was then done in a complex layered closure style with wide undermining and then a tension free manner was employed with a deep layer of 2-0 vicryl in the deep dermis and scarpas fascia; and then 3-0 PDS
in the mid-dermis and 3-0 monocryl in the subcuticular layer. Surgical glue was placed on the incision as well. Binder was then applied with dressings
** I am choosing this procedure based on a coding clinic I had read. "Delay of flap ligation of deep inferior epigastric vessels. Coding Clinic for HCPCS - Fourth Quarter 2011; Page: 4;5."**
Answer:
I think this is a duplicate question. It is answered in the Club Forum.
So I am thinking that for this procedure that code 15600 should be used? and not 19364 since it reads that this patient is coming in for a delayed formal flap?
The procedure is: bilateral formal _**Delayed**_ Procedure for later TRAM musculocutaneous flap reconstruction of breast cancer mastectomy site via incision of lower abdominal wall and suture ligation of bilateral deep inferior epigastric vessels. The lower abdominal planned incision was now incised with a scalpel. The incision was carried down to the fascia with a bovie electrocautery. The superior medial portion over the muscle was beveled the fat attempting to capture more perforators. We then incised the anterior rectus sheath over the medial and lateral portion of the rectus abdominis muscle bilaterally. Inferiorly; the muscles were partially transected with cautery and the DIE artery (Deep inferior epigastric)and veins were doubly ligated with 2-0 silk sutures. The closure was then done in a complex layered closure style with wide undermining and then a tension free manner was employed with a deep layer of 2-0 vicryl in the deep dermis and scarpas fascia; and then 3-0 PDS
in the mid-dermis and 3-0 monocryl in the subcuticular layer. Surgical glue was placed on the incision as well. Binder was then applied with dressings
** I am choosing this procedure based on a coding clinic I had read. "Delay of flap ligation of deep inferior epigastric vessels. Coding Clinic for HCPCS - Fourth Quarter 2011; Page: 4;5."**
Answer:
I think this is a duplicate question. It is answered in the Club Forum.
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