E523

PDF page 569 / M19

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
 SKIN AND SUBCUTANEOUS TISSUE
                                                                                                    Asst   Surg     Anae
       D. Myocutaneous, myogenous or fascia-cutaneous flaps
     Note:
     To include closure of donor site defect by any means.
# R005 Sterno-mastoid, tensor fascia lata, gluteus maximus, gracilis,
          sartorius, rectus femoris, gastrocnemius (medial and
          lateral), trapezius................................................................        6     545.00    6
# R006 Pectoralis major ...................................................................... 6 734.95              6
# R155 Latissimus dorsi or unilateral rectus abdominus.....................                    6 734.95              6
     Note:
     R006 is not eligible for payment for post-mastectomy breast reconstruction.
# R008 Lower transverse rectus abdominus flap ................................                       6     984.55    8
      Repair of abdominal defect
# Z196 - different surgeon ................................................................                377.65
# E523   - same surgeon, to other procedure............................. add                               321.00
# R009 Myocutaneous - osseous flaps e.g. pectoralis major
         myocutaneous flap with rib graft, trapezius flap with scapula
         spine...................................................................................    6     783.40    8
# R007 Other - (see General Preamble GP12) ...................................                      I.C    I.C      I.C
       SKIN GRAFTS
    A. Split thickness grafts (for burn grafts see pages M10 & M11)
# R084 Very minor, very small areas, e.g. trauma ..............................        92.30 7
# R085 Minor, medium sized areas, e.g. small or skin ulcer, breast, etc             6 140.25 6
# R086 Intermediate, large areas, e.g. trunk, arms, legs ....................       6 259.10 7
# R087 Major, complex areas, e.g. face, neck, hands ........................        6 388.00 7
# R088 Extensive major, very large area(s) ........................................ 6 567.95 6
     Note:
     The medical record must demonstrate the appropriateness of code claimed relative to size.

Master, record 1220. Record Layout PDF, page 1.

E52320250401999999990000321000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.