AHA Coding Clinic® for HCPCS - 2024 Issue 2; Ask the Editor

Reconstruction of axillary lymphadenectomy wound with LICAP flap

Following the patient’s right modified radical mastectomy and axillary lymphadenectomy, the axially lymphadenectomy wound was repaired, in part, by a lateral intercostal artery perforator (LICAP) flap. The provider indicated a Doppler probe was used to identify the LICAP within the soft tissues of the region. An inferiorly based perforator flap was designed based on this blood supply. The flap was incised with a #10 scalpel blade. Subcutaneous dissection was performed with monopolar electrocautery through the subcutaneous tissue. The superficial surface of the cutaneous aspect of the flap was de-epithelialized with monopolar electrocautery. The lateral intercostal artery perforator flap was then transposed superiorly into the axillary lymph node dissection wound and secured in place with 2-0 Vicryl sutures. This additional flap significantly improved the contour of the lateral breast and chest wall by obliterating dead space and sealing off injured lymphatic channels. How is the LICAP portion of the axillary lymphadenectomy wound repair reported? ...

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