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Tanesha Posted Tue 07th of November, 2017 08:11:30 AM
Pilonidal disease was excised with subsequent flap for the defect created. I'm not sure if I should use 11771 or 11772 and does this include the flap or should this be coded separately? He states each arm of flap measured 8 cm. Here's the excerpt: A rhomboid with 8 cm axes was measured from 1 cm beneath the sinus within the natal cleft, inclusive of the areas of previous drainage cephalad. This rhomboid was then incised along the previously made skin markings. The dissection was carried through the dermis, and through the subcutaneous fat down to the gluteal fascia using electrocautery. To the patient's left, diffuse pilonidal tracts spreading laterally were freed from surrounding tissue and included within the specimen. Once the specimens had been freed from underlying fascia, it was sent to Pathology for review. The irrigation was used, and hemostasis was achieved using electrocautery. A flap was constructed, utilizing the left upper buttocks, with each arm of the flap measuring 8 cm. The flap was mobilized using electrocautery, down to the fascia
SuperCoder Answered Wed 08th of November, 2017 06:51:34 AM


As per above mentioned report the appropriate CPT would be 11772.

CPT 11771 is used when an extensive sinus, greater than 2 cm, is present superficial to the fascia overlying the sacrum, or there are extensions. The cyst is excised and sutured in several layers. In 11772 the sinus may be infected and involves many subcutaneous extensions, which are excised. Local soft tissue flaps may be required for closure of a large defect.


Please also check the below link:



Tanesha Posted Wed 08th of November, 2017 09:45:19 AM
Thank you for your quick response. Unfortunately, I couldn't bring up the article. Could you please paste article here for me to review?
SuperCoder Answered Thu 09th of November, 2017 01:57:22 AM


Question:  A proctologist treated a patient for pilonidal cystectomy. A plastic surgeon was involved with the procedure to close the cyst via Z-plasty (he removed an 8 sq cm area of skin from the patient’s trunk). How do I code this procedure?

West Virginia Subscriber

Answer: Several codes could be considered for the cystectomy, depending on how complicated the removal was. Because a plastic surgeon helped with the case, you might select either 11771 (Excision of pilonidal cyst or sinus; extensive) or 11772 (… complicated) for the proctologist’s work.

The correct code for the plastic surgeon would be 14000 (Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less). More detailed descriptions of the code note that the surgeon might use flaps, Z-plasty, or similar techniques to complete the procedure.


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