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Bone flap placement in abdomen

  1. Default Bone flap placement in abdomen
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    What is the code of placement of a cranial bone flap into abdomen for preservation after cranial surgery for decompression of brain, post trauma?

  2. #2
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    Sounds like add on code 61316, Incision and subcutaneous placement of cranial bone graft.
    Melissa Jewett, CPC

  3. Default
    61316 is for placement of cranial bone graft onto a part of the skull. I am looking for placement of the bone flap into patient's abdomen for safe keeping awaiting placement back on skull after the brain swelling goes down.

  4. #4
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    what about 62148?

  5. #5
    Location
    North Carolina
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    I've coded these. 61316 describes creating the subcutaneous pocket & placing the bone flap in the abdomen for later retrieval.

    61316=A cranial bone graft removed at the time of a separately reportable craniectomy procedure is placed in a subcutaneous pocket to be used for future reconstruction of the skull defect. Subcutaneous storage, also referred to as subcutaneous banking, of the removed cranial bone flap preserves the viability of the bone for future use as an autogenous bone graft. An incision is made in the skin of the abdomen and a subcutaneous pocket is fashioned. The cranial bone flap removed during the craniectomy procedure is placed in the subcutaneous pocket and the skin and subcutaneous tissue is closed over the bone flap.

    62148 is to report the graft retieval during the subsequent cranioplasty to repair the skull

  6. #6
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    Can you provide the source of the information provided 61316. The 2010 coders desk reference has a completely different description of that procedure.

    thanks!

  7. #7
    Location
    North Carolina
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    Quote Originally Posted by rlcohen76 View Post
    Can you provide the source of the information provided 61316. The 2010 coders desk reference has a completely different description of that procedure.

    thanks!
    1) Custom Coder provided this description of the procedure

    2) Question:

    What is the best code for the subcutaneous placement of a bone flap in the abdominal region after craniectomy surgery? My surgeon said he is placing the bone flap in the abdomen for storage. I’m thinking about using the abdominal exploration code 49000 (Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure). What do you recommend?


    Answer:

    Use +61316 (Incision and subcutaneous placement of cranial bone graft. List separately in addition to code for primary procedure) for this activity. Notice that +61316 is an add-on code and is not reported alone. You’ll want to report +61316 with the primary procedure as directed by CPT using 61304, 61312, 61313, 61322, 61323, 61340, 61570, 61572, 61680-61705.

    http://www.karenzupko.com/resources/...hive_2008.html

    3) Also...Neurosugery Coding Alert 2008 Vol 9 Volume 3

    http://www.codinginstitute.com/artic...one_Flaps.html

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