Complex Closure of Free Flap Donor Site

Complex Closure of Free Flap Donor Site

December 3, 2020

Question:
I did a right anterolateral thigh free flap and had to close the right thigh wound (4 x 8 cm) with undermining in either direction to close the wound without any significant tension. Can I also code a complex repair (13100, +13101) with the free flap code?

Answer:
Bringing the wound edges directly is included in the free flap code. However, CPT says that repair of donor site requiring skin graft or local flaps (e.g., adjacent tissue transfer requiring a separate skin incision to create a secondary defect) may be separately reported. Additionally, Medicare has a National Correct Coding Initiate (NCCI) edit between the free flap codes and the complex repair codes which could not be overridden because the procedures are in the same area. So, no, a complex repair code would not be used for closure of the flap donor site.

*This response is based on the best information available as of 12/03/20.

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