My doc excised an ear lesion on the helix and closed it using a 9cm chondrocutaneous advancement flap. Should this be coded using 14060 or does the fact that ear cartilage is involved in the flap kick it out of this code? Would 17999 or even 69399 be better? Here's the flap portion of the note:
Following this the planned flap was designed in the standard fashion for helical rim advancement. An incision was made inferior and proximally from 2cm down to probably 1.5 cm in width along the helical rim. This incision was carried through the skin and cartilage to make sure there was a good rim of viable tissue and appropriate vascular pedicle. This was then advanced to the area of the helical root, and an incision was made around the helical root to advance the cutaneous tissue toward the other advancement flap. Once they were put into place, the through and through cartilage, and the perichondrium, were used to put the flap in place. The subcuticular layer was closed in this manner all the way around the cartilage. Once this was accomplished, the skin was closed with 5-0 Nylon and 6-0 Nylon sutures.
Any insight would be much appreciated!
Following this the planned flap was designed in the standard fashion for helical rim advancement. An incision was made inferior and proximally from 2cm down to probably 1.5 cm in width along the helical rim. This incision was carried through the skin and cartilage to make sure there was a good rim of viable tissue and appropriate vascular pedicle. This was then advanced to the area of the helical root, and an incision was made around the helical root to advance the cutaneous tissue toward the other advancement flap. Once they were put into place, the through and through cartilage, and the perichondrium, were used to put the flap in place. The subcuticular layer was closed in this manner all the way around the cartilage. Once this was accomplished, the skin was closed with 5-0 Nylon and 6-0 Nylon sutures.
Any insight would be much appreciated!
