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matrix removal with adjacent tissue transfer

Nathan Posted Sat 08th of February, 2020 19:11:28 PM
Adjacent tissue transfers are never coded with excision codes 11401-11446. However, if i need to reflect the proximal toenail fold in order to completely visualize the entire nail and nail matrix for removal and then need to close the nail fold with an advancement flap (<10sqcm), is it appropriate to code both separate procedures; 11750 and 14040?
SuperCoder Answered Mon 10th of February, 2020 05:02:16 AM

 

Hi,

Thank you for the Question!

As per NCCI manual Adjacent, tissue transfer or rearrangement procedures include excision (CPT codes 11400-11646) and repair (12001-13160). As per NCCI there is no edit between 11750 and 14040. If your documentation support advancement flap codes, then you can report it with excision of nail procedure code.

Adjacent tissue transfer or rearrangement procedures mainly performed for skin grafts necessary to close secondary defect is considered an additional procedure. The primary defect resulting from the excision and the secondary defect resulting from flap design to perform the reconstruction are measured together to determine the code.

 

Hope that Helps!

Nathan Posted Tue 11th of February, 2020 20:52:57 PM
That clarifies it. thank you
SuperCoder Answered Tue 11th of February, 2020 23:40:56 PM

Thank you, happy to help.

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