Wiki Revision Carpal tunnel/Hypothenar Fat Pad cpt

[kpichon@dsmcapitalortho.com]

Can someone weigh in on the correct coding of the attached op report? The provider has indicated CPT 64721-22 and 15736. Our coder coded as 64708 and 14040. thanks for the help

 

[NRaizman]

First of all, this is 64721+22, not 64708. This is clearly a revision carpal tunnel release.

As far as the flap is concerned, a hypothenar fat pad flap can be coded either 15736 or 15740 - I prefer the former. BUT it requires the naming of the pedicled vessel, and this op note fails to do that. The work is for an adipofascial flap and should be captured by that CPT. If the surgeon doesn't describe the adipofascial flap being elevated, being based on a named anatomic vessel, and being mobilized and inset, it will not pass an audit. This could be rewritten or amended to describe the appropriate work, otherwise it would fall to 14040, which has significantly lower value.
N.

 

[kpichon@dsmcapitalortho.com]

First of all, this is 64721+22, not 64708. This is clearly a revision carpal tunnel release.

As far as the flap is concerned, a hypothenar fat pad flap can be coded either 15736 or 15740 - I prefer the former. BUT it requires the naming of the pedicled vessel, and this op note fails to do that. The work is for an adipofascial flap and should be captured by that CPT. If the surgeon doesn't describe the adipofascial flap being elevated, being based on a named anatomic vessel, and being mobilized and inset, it will not pass an audit. This could be rewritten or amended to describe the appropriate work, otherwise it would fall to 14040, which has significantly lower value.
N.

thank you so much!