Adjacent tissue transfer cleft lift closure for pilonidal defect

Joyce Burchett

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Mount Auburn, IL
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Need help with coding of this procedure. Patient has recurrence of pilonidal disease. Colon/Rectal surgeon excised the diseased tissue. Plastics is doing the closure. After excision of diseased tissue, plastics entered to evaluate the tissue. The wound was fairly wide, but there was the ability to rearrange tissue for closure. A flap was designed on the right medial buttock. A 15-blade was used to incise through skin. This tissue was deepithelialized. The dermal skin junction was then released with electrocautery. Next, the contralateral fascial plane was released on the wound bed to allow for advancement of the superficial tissue. The undermining was performed approximately 1 -1.5 cm. Next a 10-mm Jackson-Pratt drain was placed & tunneled out superiorly & sutured into place with nylon suture. Next, 2-0 PDS was used in figure of eight fashion to tack the leading edge of the deepithelialized skin flaps down to the contralateral fascia. Next, the released dermal edge was then sewn to the released fascial plane of the left medial wound edge. Then, 2-0 PDS was also used in a deep dermal fashion to approximate the deep dermis. Then, 3-0 nylon was used in an interrupted fashion to approximate the skin. Defect 10 x 5 x 3. Flap size 11 x 2.5 cm. Overall closure length is 14.5 cm. Physician want to use 14001 but the coder thinks it should be 14301 & 14302. I can't locate any information for coding of this procedure. Can anyone help?:confused:
 
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4,466
Location
Milwaukee WI
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Size of Flap

If I'm reading this correctly, the size of the flap is documented by the physician as: Flap size 11 x 2.5 cm.
This is 27.5 sq cm, so the correct code would be 14001

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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