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Kathy Posted 4 month(s) ago
I have a provider who wants to bill a 15734 with a pilonidal cyst. I've researched this and don't believe he qualifies for the 15734. He's stating "Fasciocutaneous flaps were made bilaterally for about 2 inches to the left and to the right. Closure was obtained with a 30-v loc suture, pulling the tissue to midline w/o any tension. 3 layers closed, fascial layer, subcutaneous layer & subcuticular layer; skin closure reinforced w/ 3-0 mattress sutures". But I'm having trouble explaining to him WHY this doesn't qualify. I presented him with the Lay descriptions & clinical responsibility from SuperCoder, but he's still questioning it. Can you please help me with the appropriate language to show him why this doesn't qualify? Thanks.
SuperCoder Posted 4 month(s) ago

Hi,

Code 15734 is used to report the flap donor site.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. 

 

As per your limited documentation we are not able to evaluate what procedure physician is doing. We would require more detail about the procedure. 

"Fasciocutaneous flaps were made bilaterally for about 2 inches to the left and to the right. Closure was obtained with a 30-v loc suture, pulling the tissue to midline w/o any tension. 3 layers closed, fascial layer, subcutaneous layer & subcuticular layer; skin closure reinforced w/ 3-0 mattress sutures".  This seems physician is preparing fasciocutaneous flaps from trunk area but the documentation does not describe rotattion of the prepared flap from the donor area to the site needing repair and suturing the flap in place. 

Thanks!

 

Posted by Kathy, 4 month(s). There are 2 posts. The latest reply is from SuperCoder.

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