How To Use CPT Code 15650

CPT code 15650 describes the transfer of an intermediate pedicle flap from its donor site to a different location on the patient’s body. 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 15650?

CPT 15650 is used to describe the transfer of an intermediate pedicle flap from its original donor site to a new location on the patient’s body. This procedure involves moving a previously created pedicle flap while leaving a part of the flap connected to its base at the donor site to maintain blood supply. The purpose of this transfer is to place the flap at the target recipient site for reconstruction or repair.

2. Official Description

The official description of CPT code 15650 is: ‘Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location.’

3. Procedure

During the procedure, the healthcare provider raises a previously created pedicle flap and places it at the target recipient site while keeping a connection to its base at the donor site. This connection ensures a continued blood supply to the flap. The provider may need to incise around the flap to raise it and tunnel the structures under the skin to reach the new target site without severing the connection to blood vessels. In some cases, multiple transfers may be necessary to reach the final target site, which is known as “walking the flap.”

4. Qualifying circumstances

CPT 15650 is performed when there is a need to transfer an intermediate pedicle flap to a different location on the patient’s body. This procedure is typically used for reconstructive or repair purposes. It is important to note that CPT 15650 should not be reported if the transfer is performed during the same surgical session as the pedicle flap formation. In such cases, other codes, such as 15570-15576, should be used.

5. When to use CPT code 15650

CPT code 15650 should be used when the provider performs an intermediate transfer of a pedicle flap to a recipient site during a separate operative session from the initial pedicle formation surgery. If the transfer is performed during the same surgical session, a different code should be used. It is important to accurately document the details of the procedure to support the use of CPT code 15650.

6. Documentation requirements

To support a claim for CPT 15650, the healthcare provider must document the following information:

• Reason for the transfer and the need for reconstruction or repair
• Details of the pedicle flap, including its original donor site
• Date and time of the transfer procedure
• Specific techniques used during the transfer
• Location of the target recipient site
• Any additional procedures performed in conjunction with the transfer
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 15650, ensure that the procedure meets the criteria for an intermediate pedicle flap transfer. It is important to accurately document the details of the procedure and use the appropriate CPT code based on whether the transfer is performed during the same surgical session as the pedicle flap formation or as a separate operative session. CPT code 15650 should not be reported if the transfer is performed during the same session as the pedicle flap formation. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT code 15650 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 15650

There are several similar codes to CPT 15650 that describe different types of flap transfers. These include:

• CPT 15570: Immediate flap transfer, including closure of donor site
• CPT 15571: Immediate flap transfer, including closure of donor site; forehead, cheek, chin, mouth, neck, axilla, genitalia, hands, and/or feet
• CPT 15572: Immediate flap transfer, including closure of donor site; eyelids, nose, ears, and/or lips
• CPT 15574: Immediate flap transfer, including closure of donor site; forehead, cheek, chin, mouth, neck, axilla, genitalia, hands, and/or feet; with microvascular anastomosis
• CPT 15576: Immediate flap transfer, including closure of donor site; eyelids, nose, ears, and/or lips; with microvascular anastomosis

9. Examples

1. A plastic surgeon transfers an intermediate pedicle flap from the abdomen to the wrist to reconstruct a defect caused by trauma.
2. A reconstructive surgeon moves a pedicle flap from the thigh to the breast to repair a post-mastectomy defect.
3. A maxillofacial surgeon transfers a pedicle flap from the forehead to the nose to reconstruct a nasal defect.
4. A hand surgeon moves a pedicle flap from the forearm to the finger to repair a finger tip amputation.
5. A plastic surgeon transfers an intermediate pedicle flap from the back to the scalp to reconstruct a scalp defect caused by a tumor removal.
6. A reconstructive surgeon moves a pedicle flap from the chest to the lower leg to repair a chronic wound.
7. A maxillofacial surgeon transfers a pedicle flap from the thigh to the lower jaw to reconstruct a mandibular defect.
8. A hand surgeon moves a pedicle flap from the upper arm to the thumb to repair a thumb amputation.
9. A plastic surgeon transfers an intermediate pedicle flap from the abdomen to the buttock to reconstruct a gluteal defect.
10. A reconstructive surgeon moves a pedicle flap from the back to the foot to repair a foot ulcer.