Wiki Need Help With Exc lesion With A to T Flap

[Hopp]

Hi! Wondering if I anyone can help coding the following:
Exc forehead lesion with FS (Clear Margins)- Triangular portion of skin was exc. superiorly and a horiz.incision was made at base of the circle of the initial incision and extended outward on each side to
create 8 sq cm A to T Adv.Flap. Redundant crescents were excised from the flaps inferiorly on each side and rotated medially to close defect. Subcu.tissues were approx.using inverted 409 Biosyn and skin was closed with interrupted 5-0 nylon.
CPT 14040 I believe is correct for the flap but just wondering if appropriate to also use Code 13131 - 59 (if not when would you use this code) Thanks in advance for any help concerning this
Deb,CPC

 

[cynthiabrown]

the 14000 series includes closure, you could use the repair code for excision of lesion if closure was layered or complex

 

[Hopp]

Thank you for response-Still uncertain!

I thought that CPT 14000 included layered closure. Was just wondering based
on note posted if that would warrant CPT code 13131 with 59.
Confused! TIA
Deb,CPC

 

[mitchellde]

the flap repair is the closure in this case so you would not also add the complex closure as that would indicate 2 different wounds. The excision codes include the simple repairs, layered and complex repairs may be coded in addition to the excision. However when a flap is used to repair the defect then you do not also code the excision. This is all stated in the CPT book.