Component Separation Procedure

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Question:

My doctor did a component separation technique to close a large abdominal defect created by the general surgeon after repair of a large incisional hernia. Is this closure included in the general surgeon’s code for the hernia repair or can my plastic surgeon bill his own code? If we can bill, what CPT code should I use?

Answer:

Good question. The global package for surgical CPT codes includes the usual primary closure. However, the component separation technique goes above and beyond the usual closure and is separately billable using the muscle/myocutaneous flap code, 15734 (Muscle, myocutaneous, or fasciocutaneous flap; trunk). Oftentimes bilateral muscle flaps are used for closure of the large defect. Remember, CPT does not assign laterality to the flap codes such as 15734; therefore, 15734 would be reported once per muscle flap harvested. Modifier 59 (distinct procedural service) may be necessary on the second code to show it was a completely separate procedure (15734, 15734-59).