Wiki Anatomy Question, as it relates to coding

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sinman0531

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Would you/does coding anatomy consider the sacrum a part of the trunk, or a part of the lower extremities?

Surgeon created a muscle flap using the gluteal muscle for a 4 year old. The operative not simply says :
The flaps measured 8 x 3 cm bilaterally and were based off the gluteal artery perforators
Click to expand...

Surgeon pushed back that it should be coded as a "trunk" muscle flap, which has a higher RVU. I'm not sure if the SGAP (since I am assuming thats what he meant, based on the pushback) would be considered the trunk, or the lower extremity. Is there any guidance on this anywhere?
 
Not that this is the same code, but this info describes the trunk: https://www.aapc.com/codes/cpt-codes/15734 "from the trunk (the area between the neck and the waist)"
The sacrum is part of the trunk but if you start talking about flaps from the glutes, not sure.
Have you checked CPT Assistant or AHA Coding Clinic? That would be a reputable source. Anything in the beginning of the integumentary section in the CPT book?
 
Hi Sinman0531
I believe the sacrum is part of the trunk since it connects the hip bones. So the CPT 15734 flap for trunk seems to be best CPT for the sacral area. Also many dx codes for each the sacrum area (M49.88, M54.18, M46.38 M76.0 S76, R07.82 G57.00 M62.838 just to name a few) and lower extremities. The lower extremity includes the hip, knee, and ankle joints, and the bones of the thigh, leg, and foot. There are 5 sections of the spine with 33 sections. Sacrum code is S1-S5 or 5 parts. The physician is correct sacrum is part of the trunk holding up that pelvic.
I hope helped you.
Lady T
 
What was the flap being used for?
If you look at diagrams of where it is being taken from and the procedure, it is most likely trunk.
 
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