Question Skin Grafting and Closure

apoland

Contributor
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Hi everyone,
I have a malignancy excision 6.5 x 4 cm; 1.5cm of the defect was closed with a layered closure the remaining 5 x 3 cm was grafted closed with a FTSG. The surgeon wants to code for the layered closure, however, I question if this is bundled to the graft?

Thanks
Autumn
 
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Interesting dilemma! Not knowing what body area was worked on, I chose the face to review for CCI edits - 11646, 15240, & 12051. My first thought was you should not code for the layer closure as it would be bundled with the FTSG, as there is a CCI edit between the two but you can override it with a modifier. My next thought was if the surgeon felt they did not need to do a larger FTSG to close the defect and took a conservative approach and closed it two ways, why should they not get paid for the work performed. I would bill the layered closure with a Modifier XU or Modifier 59 depending on the carrier.

There are a lot of areas in coding that are gray, follow the coding guidelines and make sure the providers documentation supports your claim.

Jennifer
Coding Analyst
 
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