AHA Coding Clinic® for ICD-9 - 2010 Issue 1; Ask the Editor

Failed Lattisimus Dorsi Free Flap

The patient, a 62-year-old male, was diagnosed with skin cancer that had eroded into his frontal bone as well as brain. The patient underwent cancer resection with planned reconstruction of his calvarial bone defect via latissimus dorsi free flap. The reconstructive surgery involved the creation and placement of a muscle flap in the calvarial defect. Because a split thickness skin graft was needed to cover the flap, skin graft was harvested from the thigh. The latissimus dorsi muscle was raised, placed into the defect and arterial and venous anastomoses were accomplished. Unfortunately, the anastomosis was not patent. Attempted repair of the anastomosis with suture was unsuccessful. Since there was no palpable flow, the latissimus dorsi free flap was deemed nonviable. The flap was taken down. What are the appropriate ICD-9-CM diagnosis codes for failed latissimus dorsi free flap and the appropriate codes for the procedures performed? ...

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