Wiki Flap reconstruction for Gustillo Type IIIB/IIIC

[alsmedicx2]

My co-worker and I are having a rather large disagreement on how to code these procedures. We will have a patient come in with a Gustillo type IIIb or IIIC and ortho will do their thing and then we will provide the flap coverage to cover the open wounds. I say we use the fracture codes since they include the open wounds. My co-worker disagrees and wants to use unspecified open wound codes. Any thoughts on this and does anyone have any articles that will settle this once and for all? Unfortunately my system doesn't allow me to cut and paste the op note and it's a four page note so I can't really type it all here but any help would be appreciated.

 

[bostonmom]

Flap

I would agree with you, you want to chose a ICD10 code to the highest specificity that you can. Unspecified wound, will not get the claim paid. I would chose the fracture code also.

 

[LMS62682]

What about Z48.1 encounter for planned postoperative wound closure if that is all you are doing.

 

[ca1007]

Hello OP,

I am a researcher in plastic surgery and was wondering if you could let me know how you code these free flaps. Do you include a muscle excision code for donor site and then a replacement code for recipient site (wound)?