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Divide cross finger flaps

Mary Posted Mon 18th of June, 2012 13:04:59 PM

Physician performed a 15240 and 15574 on traumatic amputation of fingertip. Now he wants to "divide cross finger flaps" on same finger-I have come up with 15574 with modifier 58-can anyone help? Thanks!

SuperCoder Answered Mon 18th of June, 2012 17:21:00 PM

Report Division and Inset

After enough time has passed for vascular development at the recipient site, the surgeon cuts the pedicle near the repair site and shapes and sutures the final graft. The surgeon may also return a portion of the pedicle to its original position, or in some way complete closure of the pedicle defect. You should report this step using the appropriate code from this list:

15600 -- Delay of flap or sectioning of flap (division and inset); at trunk

15610 -- ... at scalp, arms, or legs

15620 -- ... at forehead, cheeks, chin, neck, axillae, genitalia, hands or feet

15630 -- ... at eyelids, nose, ears, or lips.

Example: The surgeon prepares a pedicle flap from the cheek and transfers it to a defect site on the nose, which you should report as 15574. One week later, the surgeon completes the transfer, performing the flap division and inset, which you should code as 15620.

Watch for modifier: You will need to use modifier 58 (Staged or related procedure by the same physician during the postoperative period) with 15620 in this example. "Because the sectioning of the pedicle flap falls within the pedicle formation[15574] global period, you need a modifier to tell the insurer that the service is a staged procedure and therefore payable

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