AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 3; Ask the Editor

Breast Reconstruction with Neurotization

A patient, who is status post right mastectomy, is admitted for deep inferior epigastric perforator (DIEP) flap breast reconstruction with nerve conduit neurotization. During surgery, the recipient site was prepared, the abdominal fascia was dissected and the perforator flap was harvested. The donor nerve was identified and dissected for later neurotization. At the recipient site, the internal mammary artery and vein were prepared at the fourth intercostal space for anastomosis to the donor perforators. Under the operating microscope, the nerve repair is accomplished using a Neurogen alloplastic conduit to coapt the donor and recipient nerves. The cut ends of the nerves were secured to the conduit with suture. When DIEP flap neurotization using the intercostal and sensory nerves as a conduit is accomplished, is the neurotization coded separately? ...

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