AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2018 Issue 2; Ask the Editor

Transverse Rectus Abdominis Myocutaneous (TRAM) Delay

A woman, who had undergone bilateral mastectomy and radiation therapy, was admitted for transverse rectus abdominis myocutaneous (TRAM) delay procedure. At surgery, incisions were made over the inferior aspect of the rectus muscle bilaterally and the rectus muscle was retracted medially. The vascular pedicle, comprising the inferior epigastric artery and vein, were identified and doubly ligated with surgical clips on the right as well as the left. According to studies, ligation of the deep epigastric vessels before TRAM flap reconstruction (TRAM delay) may improve blood circulation to the TRAM, and can decrease the rate of flap ischemia. What is the code assignment for this procedure? ...

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