AHA Coding Clinic® for HCPCS - 2022 Issue 2; Ask the Editor
Biodegradable temporizing matrix (BTM) skin substitute
A patient suffering from mandibular osteoradionecrosis due to head and neck radiation and chemotherapy, presents for excision of the mandibular bone, bone grafting and application of Biodegradable Temporizing Matrix (BTM) intraorally. The abnormal mucosa overlying the retromolar trigone and mandibular ramus, angle and body was removed via electrocautery. The exposed necrotic mandibular bone was removed using a curette and drill until healthy, bleeding bone was encountered. The wound was irrigated. The bone graft was applied to the area of resection which measured 5x3 cm. BTM, secured with 3-0 sutures, was fashioned to cover the bone graft and fill the mucosal defect. Lastly, a dressing was fashioned and secured with 2-0 silk sutures.What is the appropriate code for the application of the BTM to an intraoral mouth cavity defect? Although BTM is considered a skin graft substitute, in this case, would the application of the BTM be assigned a skin substitute code when applied to mouth mucosa, or would the use of the BTM be considered a dressing or a filler for the mucosal defect and for the covering of the bone graft? ...
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