Wiki How do you measure an advancement flap?

[cbellaga64]

My plastic surgeon performed only closure following a Mohs excision. The wound size was 1.6 x 1.8 cm. Bilateral tissue advancement of 2.0 x 2.0 cm was accomplished. The surgeon added the size of the wound plus the 2 flaps together for a total of 10.88 sq. cm. Should the wound size be added to this measurement?

 

[nsteinhauser]

Per CPT (professional edition) instructions, for codes 14000 - 14302, "the primary defect resulting from the excision and the secondary defect from flap design to perform the reconstruction are measured together to determine the code." This isn't like free grafts, where the code is determined by the size of the recipient area alone.
In your case - 1.6 x 1.8 = 2.88 sq cm for the primary defect.
2.0 x 2.0 = 4.0 sq cm for the secondary defect.
2.88 sq cm + 4.0 sq cm = 6.88 sq cm.
Page 78 of the CPT Professional Edition has a picture for 'adjacent tissue repairs' that explains it. Hope this helps.