Dawn C Posted Tue 06th of October, 2015 15:01:05 PM
Please tell me if you believe it would be appropriate to bill 15734 for this procedure. It looks like a fasciocutaneous flap to me, but I would like another opinion.
At this point, we turned our attention to repairing the ventral hernia defect. We first excised any unhealthy skin and the fascial edge and then elevated the flap off the anterior fascia bilaterally, gaining at least 10 cm on each side. We then placed a piece of stratus mesh 20 x 25 cm, turned it diagonal and trimmed off the 2 corners on the 2 sides and we then placed interrupted transfascial PDS sutures all the way around the mesh and then closed his native midline fascia over the mesh underaly with interrupted figure-of-eight Nurolon sutures. After we were satisfied with this, we brought the subcutaneous flap together with interrupted Vicryl sutures. After having placed two 19-French round drains under each flap, the drains were secured in place. The subcutaneous tissue was loosly closed and managed by negative pressure wound dressing. At the end of the case, hemostasis was secure and abdomen and each layer of the tissue had been irrigated copiously with warm saline.
SuperCoder Answered Wed 07th of October, 2015 09:26:31 AM
Well, you are right with the procedure code. The physician repairs a defect area using a muscle, muscle and skin, or a fasciocutaneous flap. The physician rotates the prepared flap from the donor area to the site needing repair, suturing the flap in place. The donor area is closed primarily with sutures. If a skin graft or flap is used to repair the donor site, it is considered an additional procedure and is reported separately. Which is not done in your case. Hope it helps!