Differentiate transfers, flaps, and grafting procedures
APCs Weekly Monitor, November 7, 2008
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In this second article of a two-part series. John F. Bishop, PA-C,
Drawing a picture of a closure can help you code the procedure correctly, says Bishop. but However, you can’t bill for a closure as an adjacent tissue transfer (even if it looks like a W or a similar shape) when the physician documents “direct closure” in his or her operative notes.
“[That shape is] just the way it ended up,” he says. “The physician didn’t go to all the extra time and effort to develop the W closure or the V-Y advancement or whatever else.”
If the procedure requires a skin graft of some type to close the secondary defect, that is an additional procedure that you can also code, says Bishop. If a patient has primary and secondary defects together, with a primary defect and a secondary defect resulting in a flap design, add the overall measurements.
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