• Layered and complex repairs are separately reportable. . PROCEDURE: Wide local excision 1.5 cm total dimension with bilobed flap reconstruction. Cosmetic Procedures: Procedures or services that change or improve appearance without significantly improving physiological function. Debridement / Recipient site preparation; Z / W Plasty Etc; Cross / Fillet Finger; Form / Delay / Section Pedicle; Axial; Free I need help coding a bilateral second webspace syndactyly which required skin flaps x3 on the right foot, and x2 on the left foot. Congenital Anomaly: A physical developmental defect that is present at the time of birth, and that is identified within the first twelve months of birth. To start, CPT changed the official coding instructions to read, “The regions listed refer to a donor site when a tube is formed for later transfer or when a “delay” of flap occurs prior to transfer. but both of these flaps are on the primary defect. . A wide subcutaneous undermining proceeds, the extent of which is determined by the laxity of the skin and the extent of the defect. The op report reads: "On the right foot, two box incisions were made, one across the dorsal aspect of the second webspace and one across the plantar aspect of the webspace. The rhomboid flap is a type of transposition local flap commonly used in skin-cancer reconstruction on the face (cheek, temple, scalp) and pilonidal disease.The repair was first designed by Limberg for rhomboid defects of 60 and 120 degrees and now modifications to the technique have been developed. • Secondary defect closure • Size for code selection Adjacent Tissue Transfer 36 . the excision codes per CPT® guidelines. The incision is then continued laterally to the preauricular crease toward the level of the earlobe. ... • Rotation flap • Random island flap • Advancement flap Adjacent Tissue Transfer 35 • What’s not an ATT? Inferior flap 3.0cm squared including primary and secondary defects Deep Layer Sutures: 5-0 monocryl buried Skin Layer Sutures: 5-0 monocryl running, 5-0 monocryl interrupted EBL: Minimal I know if there is a graft or a rotation flap required on the secondary defect you can bill it. A Mustarde; cheek flap is a large rotation flap with its leading edge at the lateral canthus extending laterally and arching like a Tenzel flap (12). As with all sections, the CPT codes regarding deep tissue and skin flaps received a bit of a makeover for the new year. transposition flaps, advancement flaps and rotation flaps. Query: Desyndactylization with Rotational Flap . PROCEDURE: The patient was taken to the operative area where his nose was prepped and draped in the usual fashion, injected with 2% lidocaine and 1:100,000 epinephrine. Hand Surgery Flap CPT Codes.