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Thread: Delay of TRAM flap

  1. #1

    Default Delay of TRAM flap

    AAPC: Back to School
    We are new to these procedures and would appreciate your input. 19367 includes reconstruction of the breast but the reconstruction is not being done at this point. Therefore how is the procedured coded???

    Patient with infiltrating ductal carcinoma of the left breast. Patient is having left mastectomy followed by flap reconstruction.

    The patient was brought to ther operation room today for a delayed procedure to optimize the success of her schedule pedicle TRAM flap.

    ....This corresponded to the lower aspect of the eventual TRAM incision. The skin over the area corresponding to the lateral aspect of the border of the rectus muscle was incised. The soft tissue was dissected until the rectus fascia was identified. The fascia was identified and the rectus muscle was retracted medially. The deep inferior epigastric artery and veins were identified. The artery and the veins were isolated. Clips were then placed separately on the artery and the two veins. The vessels were then divided. Hemostatis was confirmed. The area was completely dry. The Scarpa's fascia was approximated with 2-0 PDS suture. The skin was then closed in layered fashion ......

  2. #2
    Join Date
    Apr 2007
    ERIE, PA


    look at CPT 15600, this is the code that I use for a delayed TRAM flap.

    This is the first procedure that is done 7-10 prior to 19367.

    When you code for the 19367 make sure you use a 58 modifier to show that this was a staged procedure.

  3. #3


    totally agree

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