How To Use CPT Code 15572

CPT code 15572 describes the formation of a direct or tubed pedicle, with or without the transfer of scalp, arms, or legs. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 15572?

CPT 15572 is a code used to describe the formation of a direct or tubed pedicle, with or without the transfer of scalp, arms, or legs. This procedure involves the preparation of a skin flap using the patient’s healthy skin and tissue to cover an injury or wound on the body. The flap may or may not be transferred to the recipient site, depending on the specific case.

2. Official Description

The official description of CPT code 15572 is: ‘Formation of direct or tubed pedicle, with or without transfer scalp, arms, or legs.’

3. Procedure

During the procedure, the healthcare provider prepares a direct or tubed pedicle flap by incising and lifting the edges from a healthy part of the patient’s skin and tissue. For a tubed pedicle, the provider stitches the edges together to give the skin a tubular shape. The flap may be transferred to the recipient site, or it may remain connected to the donor site. The connection allows the recipient site to receive blood supply from the donor site, promoting tissue nourishment and growth. This procedure is specific to the scalp, arms, or legs.

4. Qualifying circumstances

CPT 15572 is typically performed when a patient has an injury or wound on the scalp, arms, or legs that requires the formation of a direct or tubed pedicle flap. The procedure is performed by a healthcare provider who is appropriately trained and qualified to perform this specific technique. The decision to perform the procedure is based on the patient’s individual circumstances and the provider’s clinical judgment.

5. When to use CPT code 15572

CPT code 15572 should be used when a healthcare provider performs the formation of a direct or tubed pedicle, with or without the transfer of scalp, arms, or legs. This code is specific to this particular procedure and should be used when documenting and billing for it.

6. Documentation requirements

To support a claim for CPT code 15572, the healthcare provider must document the following information:

• Patient’s diagnosis or reason for the procedure
• Description of the procedure performed
• Details of the direct or tubed pedicle formation
• Whether the flap was transferred to the recipient site or remained connected to the donor site
• Any additional relevant information or findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 15572, ensure that the procedure performed matches the description of the code. It is important to accurately document and code the procedure to ensure proper reimbursement. If the pedicle flap is transferred to the recipient site at a separate operative session, use code 15650 for the transfer service. Be aware of any specific guidelines or requirements from insurance payers regarding the use of this code.

8. Historical information

CPT code 15572 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 15572

There are several similar codes to CPT code 15572 that describe different procedures or variations of the formation of pedicle flaps. These codes include:

• CPT 15570: Formation of direct or tubed pedicle, with or without transfer; forehead
• CPT 15571: Formation of direct or tubed pedicle, with or without transfer; nose
• CPT 15573: Formation of direct or tubed pedicle, with or without transfer; trunk
• CPT 15574: Formation of direct or tubed pedicle, with or without transfer; neck
• CPT 15576: Formation of direct or tubed pedicle, with or without transfer; genitalia

9. Examples

1. A plastic surgeon performing the formation of a direct pedicle flap to cover a scalp injury.
2. An orthopedic surgeon preparing a tubed pedicle flap to cover a wound on a patient’s leg.
3. A dermatologist performing the formation of a direct pedicle flap to cover an arm injury.
4. A reconstructive surgeon preparing a tubed pedicle flap to cover a scalp wound.
5. A general surgeon performing the formation of a direct pedicle flap to cover a leg injury.
6. A vascular surgeon preparing a tubed pedicle flap to cover an arm wound.
7. A plastic surgeon performing the formation of a direct pedicle flap to cover a scalp injury.
8. An orthopedic surgeon preparing a tubed pedicle flap to cover a wound on a patient’s leg.
9. A dermatologist performing the formation of a direct pedicle flap to cover an arm injury.
10. A reconstructive surgeon preparing a tubed pedicle flap to cover a scalp wound.