Q&A Adjacent Tissue Transfer and Flaps

[Mpoole714]

Hi,
I am having difficulty differentiating between adjacent tissue transfers and flaps. Could you provide clarification on when you would code one versus the other?

Thank you!

 

[Alicia Scott]

http://www.entusa.com/rotation_advancement_20071212.htm Flap

Tissue transfer is when they take tissue from someplace else and cover the wound. A flap is also taking tissue but from close to the woud and it is flopped over the wound.

The vascular system is something that you pay attention to. As I understand it a flap keeps the same vascular system and a tissue transfer does not.

 

[Dolores Soliz]

Thanks for the tip Alicia

 

[Laureen]

Fip Flop ha ha

 

[Luna]

Hi,
I am having difficulty differentiating between adjacent tissue transfers and flaps. Could you provide clarification on when you would code one versus the other?

Thank you!

Hi Mpoole714,

I'm with you. It can get confusing. I questioned too, how do you know if you need to code from Adjacent Tissue Transfer or Rearrangement (14000-14350) or Flaps (Skin and/or Deep Tissues) (15570-15738).
I would get confused between something that would maybe be considered a "rearrangement" or a "flap", because flapping a piece of skin this way from that way seemed like a rearrangement to me…and yet it also sounded like a flap...and well, is a flap a transfer or is a flap a flap??? …A flap process sounds very like an adjacent tissue replacement but there are important differences.


One resource (a 2013 AAPC textbook) listed 3 things to keep in mind when distinguishing between the two services:

·The base of the pedicle flap is eventually cut or severed from its original blood supply after the skin transfer has been completed. (15570-15738)In an adjacent tissue transfer, the base remains intact permanently. (14000-14350)

·Pedicle flaps are formed on an area distant from the defect where it is being transferred to. (15570-15738) In an adjacent tissue transfer, transfer is made from a local flap. (14000-14350)

·Pedicle flaps are often completed in multiple stages but can be formed and transferred in one stage. (15570-15738) Adjacent tissue transfers are completed in a single stage. (14000-14350)

Understanding the anatomy of the integument also helps. Remember that flap procedures that fall in the 15550-15738 range are going to involve more than the "skin". They are going to include skin and deep tissues- or only deep tissues; muscle, vascular structures and sometimes nerves will all be part of the "flap".


Those are some of the things I keep in mind to help me distinguish what code range I need to be looking at when the procedures sound similar. I still get stumped, and have to Google for pictures, articles and videos to help me visualize the processes involved. But, I thought I'd share those tips with you. They really helped me.