Question Tissue Transfer/Rearrangement Vs. Myofascial flap closure

sisadavis

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I have a plastics surgeon that is new to our health system. We are really struggling to come to an agreement when it comes to myofascial flap closures vs. tissue transfers.

In this case she performed a Z-plasty with gluteus maximus muscle. Her dictation reads...a Z-plasty with the gluteus maximus muscle was designed. This was elevated thoroughly and then the area was irrigated with 3000 mL of saline using Pulsavac. A drain was placed and brought out through a separate stab incision. Hemostasis was maintained. 30 mL of Marcaine 0.25% plain was injected. The muscle layer was then closed with 2-0 PDS followed by subcu with 2-0 PDS and 3-0 PDS.

She is wanting this submitted as 15734 however, with my research I am leaning towards 14301. As CPT manual lists Z-plasty specifically under tissue transfers. Her argument is that she used the muscle so it should support 15734.

I'm hoping someone may be able to provide some additional guidance. Any information would be appreciated. Thank you!
 
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