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The CPT® Code 15620 pertains to the surgical procedure known as the delay of flap or sectioning of flap, specifically performed on anatomical sites including the forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet. The term "delay of flap" refers to a surgical technique that involves a staged division of the flap to improve its vascular supply, thereby enhancing the viability of the tissue that will be used for reconstruction. This technique is often employed to ensure that the flap receives adequate blood flow before it is fully detached and repositioned. Conversely, "sectioning of flap" involves the complete transection of the flap, followed by its inset at the recipient site where it will be utilized to cover a defect. During the delay maneuver, the pedicle, which is the base of the flap that contains its blood supply, is partially divided. This action promotes better circulation to the flap tissue, making it more robust for subsequent surgical steps. Once the flap is sectioned, the surgeon will complete the inset and closure of the defect at the recipient site. Any portion of the flap that is not utilized is returned to the donor site. In cases where the donor site has been closed with a skin graft, the graft may be removed and replaced with the remaining flap tissue. If additional coverage is necessary at the donor site, a separate skin graft or local flap may be applied. It is important to note that specific codes are designated for different anatomical locations, with CPT® Code 15620 specifically reserved for procedures involving the aforementioned areas of the body.
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The procedure associated with CPT® Code 15620 is indicated for various conditions where tissue reconstruction is necessary in the specified anatomical areas. The following are the explicit indications for performing this procedure:
The procedure for CPT® Code 15620 involves several critical steps that ensure the successful delay and sectioning of the flap. Each step is detailed as follows:
Post-procedure care following the delay of flap or sectioning of flap is critical for ensuring optimal healing and minimizing complications. Patients are typically monitored for signs of adequate blood flow to the flap, which may include assessing color, temperature, and capillary refill. Pain management is also an essential component of post-operative care. Patients may be advised to keep the surgical area clean and dry, and to follow specific wound care instructions provided by the surgeon. Follow-up appointments are necessary to evaluate the healing process and to address any concerns that may arise. If additional procedures, such as skin grafting, are required at the donor site, these will be discussed during follow-up visits.
| Short Descr | DELAY FLAP F/C/C/N/AX/G/H/F | Medium Descr | DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F | Long Descr | Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5A - Ambulatory procedures - skin | MUE | 2 | CCS Clinical Classification | 172 - Skin graft |
| 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | E2 | Lower left, eyelid | E4 | Lower right, eyelid | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F9 | Right hand, fifth digit | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | TA | Left foot, great toe | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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