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The CPT® Code 15650 refers to the procedure of transferring an intermediate pedicle flap, which is a type of surgical graft. In this context, a pedicle flap is a section of tissue that remains attached to its original blood supply while being moved to a different location on the body. This procedure is typically performed after the recipient site, where the flap will eventually be placed, has been adequately vascularized and deemed viable for the graft. The term "walking the flap" is commonly used to describe this process, as it involves gradually moving the flap closer to its final destination in a series of steps. The flexibility of this procedure allows it to be performed at various locations on the body, and it can be repeated multiple times if necessary before the flap is finally secured in place. This technique is crucial in reconstructive surgery, particularly in cases where tissue needs to be relocated to repair defects or enhance aesthetic appearance.
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The procedure associated with CPT® Code 15650 is indicated for various clinical scenarios where tissue transfer is necessary for reconstruction or repair. The following conditions may warrant the use of this procedure:
The procedure for CPT® Code 15650 involves several critical steps to ensure the successful transfer of the pedicle flap. Each step is essential for achieving optimal results.
Post-procedure care following the transfer of a pedicle flap is essential for ensuring proper healing and flap viability. Patients are typically monitored for signs of vascular compromise, such as changes in color or temperature of the flap. Pain management is also an important aspect of post-operative care. Patients may be advised to limit movement in the area to prevent stress on the flap. Follow-up appointments are necessary to assess the healing process and to determine when the flap can be secured in its final position. Additionally, instructions regarding wound care and signs of infection should be provided to the patient to ensure optimal recovery.
| Short Descr | TRANSFER SKIN PEDICLE FLAP | Medium Descr | TRANSFER ANY PEDICLE FLAP ANY LOCATION | Long Descr | Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location | 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) | 0 - 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 | 1 | CCS Clinical Classification | 172 - Skin graft |
| 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). | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | 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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| 2011-01-01 | Changed | Guideline information changed. |
| Pre-1990 | Added | Code added. |
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