• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Rotation Flap Billing Question

Create Wiki
J

JFoushee12

Guest
Messages
10
Location
Mt. Juliet, TN
Best answers
0
Can you bill 2 separate rotation flaps on the same defect or do you just add them together? For clarification, that is 2 separate secondary defects for the same primary defect???? See provider notes below.

Lesion Location: left anterior ala
Reason for Removal: pathology confirmed malignancy
Repair: rotation flap x 2 elected to preserve normal anatomy - superior flap corrected defect on the left nasal tip and the inferior flap was used to correct the defect on the L ala
Size of Flap: superior flap - 2.5cm squared including primary and secondary defect. Inferior flap 3.0cm squared including primary and secondary defects
Deep Layer Sutures: 5-0 monocryl buried
Skin Layer Sutures: 5-0 monocryl running, 5-0 monocryl interrupted
EBL: Minimal

I know if there is a graft or a rotation flap required on the secondary defect you can bill it. . . but both of these flaps are on the primary defect.

Look forward to seeing what you think. I cannot find anything specifically addressing 2 rotation flaps on the same primary lesion/defect. Thanks! Janelle
 
I do not have any articles to reference, but I would bill for 2 separate flaps. Because of the nasal anatomy, etc...1 flap could not be used to reconstruct both part of the nose, even though it was create by just one lesion.
 
I also have no reference, but my expectation would be that you would have to add up the square cm. of all three sites and bill as a single flap.

My logic comes from the rule for billing bilobed flaps (when a third - also contiguous - site is used as a flap to repair the second site). In that case, you have to bill as a single flap (adding up all the sizes together). I can't recall my source for that, but I know that I had researched it and that this is a definitive rule.
 
I agree with adding together all 3 areas - this will more than likely be a larger flap using the cpt code 14301 30.1 - 60 sq cm , and for each add'l 30 sq cm use cpt 14302(with appropriate units)
 
You must log in or register to reply here.
Top