Health Information Management

Differentiate transfers, flaps, and grafting procedures

APCs Insider, November 7, 2008

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In this second article of a two-part series. John F. Bishop, PA-C, CPC, MS, CWS, examines some of the more challenging integumentary codes, from flaps to unusual procedures.

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.

To read the complete article, click here. Briefings on APCs subscribers have free access to this article in the November issue via their online subscriptions.

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