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Wiki TRAM reconstruction

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lkoch829

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Question on a TRAM revision: Our doctor revised the whole flap due to a small area of necrosis, it involved undermining muscle so I don't feel 19380 really adequately represents the work done. The surgeon would also like to charge 19120 for excising the mass of necrosis, however I think 21556 would be more appropriate since its not breast tissue. Does anyone have experience with this situation and any appropriate code advise they would like to share?

Thank you!
 
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