Tissue Transfers

This type of graft uses tissue that is still connected on one side and must be connect to the blood supply and nerves.  This type of graft is also coded as a pedicle graft. Code to the body system of the deepest layer.  The qualifier identifies what is moved with the deepest layer.  Tendons and nerves can also be transferred.  Remember to code what is being transferred and not where it is going to be grafted.

Type of Transfers Different types of local transfer flaps are used to cover defects.  Here is a list of the types and their definition:

• Advancement flap is a straight forward movement of the tissue and is the most common type of transfer graft.
• Rotational flap provides for an arc type of movement, such as a half circle over to one side.
• Transportation or rhomboid type of flap that moves laterally about a pivot point into an adjacent defect. This lateral movement differentiates it from a rotation flap.
• Z-plasty flap is composed of a central limb incision and two lateral limb incisions that form a “Z”.
• Tunneled and Reverse Flap Graft is a type of graft that is tunneled under local tissue or is turned in opposite direction.

Comparison of free graft versus a pedicled flap:

The replacement graft is considered a device; the root operation. must therefore include device character 7, J, or K. 

A transfer graft is native tissue that is taking the place of a body part, therefore procedures on transferred flaps are coded as being performed at the location of the transferred flap or the body part for which the flap is taking its place.