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Is compromised flap a CMS reimbursable diagnosis for HBO? DPM referring a non-diabetic patient s/p TMA w/ dehiscence, NCD20.29 no longer specifically lists failed flap, only failed graft as a covered indication.
Oct 17, 2022 by Kathy Linde, PT
1 replies
Mike White
MD, UHM, MMM, CWS
Kathy,

This has been a controversy between coders and physicians for number of years. Most of the physicians I know will still use the T86.82_ codes for compromised flaps and grafts. I've even had coders tell me that their definitions of graft is what most physicians would call a flap. This article from AAPC in 2018 may help shed some light on it for you. https://www.aapc.com/blog/44208-dive-deeper-into-hbo-therapy-in-wound-care-centers/
Oct 18, 2022
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