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rotational flap confusion

  1. #1
    Default rotational flap confusion
    Medical Coding Books
    lesion was outlined, and 5 mm additional margins were outlined. This resulted in excision area of approximately 4.5 cm in size. Incisions were made through the skin down to the underlying bone and cartilage. Upon dissection, the mass appeared to involve the cartilage, but did not penetrate all the way through to the lining. A small, 1 cm area of nasal cartilage was removed with the specimen. It was tagged with a suture superiorly, and will be sent to pathology for further analysis. The nose was then undermined, as well as laterally onto to the cheek. Even with aggressive undermining, this was unable to achieve closure of the defect. An incision was then made in the subtarsal position, extended out to the lateral canthus, and extended laterally into a facelift incision. An additional excisionwas made in the nasal labial crease to remove soft tissue redundancy.

    14060 or 14040

    I am leaning towards14040 because he went up to the lower eyelid and across the cheek to make the flap large enough to cover the defect.

    any one have another opinion?

  2. Default
    Per CPT "Repair of primary and secondary defects requires assignment based upon the repair location and the approximate description of the area repaired." I would base the code on the location of the lesion excision since the rotational flap was performed to repair that location.

  3. #3
    Thats what I ended up doing. thank you so much for responding

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