March 12, 2015
I did a large wound closure of the perineum, buttock and testicles with 5 large separate local flaps (v-y, rotation/advancement and rhomboid). The total area of the defect was very large and required five local flaps for closure. I billed for the 5 flaps separately (14301-59 five times). Medicare paid once for 14031. How do I better bill this large repair to get paid?
Actually, the adjacent tissue transfer codes are to be reported once per defect and not once per flap used to repair the defect. So for this very large single defect you would report the stand-alone code 14301 once. The remaining area is reported using multiple 14302 add-on codes. It is not appropriate to report 14301 for each flap when a single defect is closed; rather, only one 14301 code is reported with the appropriate number of add-on codes (14302).