Cervicofacial flap cpt Each has an indicator of 1, meaning you may sometimes unbundle the codes. C. 26. In recent years, with the advent of microvascular free flap tissue transfer, the The cervicofacial (CF) flap is a random-pattern flap that provides an excellent match for cheek reconstruction. The cervicofacial flap is the mainstay of reconstruction for medium- and large-sized Purpose: The cervicofacial (CF) flap is a random-pattern flap that provides an excellent match for cheek reconstruction. All limbs of the flap were closed with interrupted Vicryl sutures. AMA CPT ® Assistant - 2017 Issue 11 (November) Skin and Muscle Flap Procedures of the Midface and Neck: An Update (November 2017) November 2017 pages 6-7 Skin and Muscle Flap Procedures of the Midface and Neck: An Update This article addresses several important changes that have been made to the Flaps (Skin and/or Deep Tissues) subsection Cervicofacial Flap Al Haitham Al Shetawi, MD, DMD Introduction: nature of the problem There are numerous reconstructive options for cheek defects, such as primary closure, skin grafting, healing by secondary intention, and local, regional, or free flaps. My claim was denied. For large cheek defects, distant flaps such as cervicofacial, cervicopectoral, deltopectoral, and pectoralis major myocutaneous flaps are excellent choices. e5 CERVICOFACIAL FLAP IN CHEEK RECONSTRUCTION. Per CPT® Assistant July 2008, Volume 18: Issue 7, Coding Communication, Adjacent tissue transfer or rearrangement Types of Tissue Transfer. I submitted my claim with CPT 14040 (advancement flap), 12052-51 (repair), and 11642-51 (malignant lesion excision). 5-8 A common flap used in cheek reconstruction is the cervicofacial (CF) flap. Despite their vascularity and availability, distant tissue flaps create a patched appearance in the highly visible and esthetically demanding facial region. The cervicofacial flap is a large, Rotation and advancement flaps; Bilobed flaps; Rhomboid flaps; and; Double pedicle flaps; Consider the following example, in which an adjacent tissue transfer code is warranted: Example 2: The surgeon excised a 0. Its cervicothoracic variant includes the dissection of the superior thoracic wall to expand the arc of rotation . The design of the TMF and cervicofacial flap after the tumour was resected. Advancement flaps involve carefully planned incisions to most efficiently close a primary defect in a linear vector. 15731 Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap) remains with the two new codes, 15730 and 15733 on each side of 15731. 1 sq cm to 30. Pt had a "excision of 4cm lesion of the left cheek with acervicofacial flap closure of the defect and excision of the left leg 2 cm mass with complex closure of the defect. 3 We experienced a case of a patient with squamous cell carcinoma (SCC) of the right cheek Deep Plane Cervicofacial Flap HEAD & NECK January 2006 47. Compound cervicofacial and cervicothoracic rotation flaps are highly versatile flaps that may be applied to a variety of defects of the cheek, orbit, periauricular region, and neck. The cervicofacial flap has been the reconstruction of choice for midface soft tissue defects for over 30 years. It may also be an option for patients not suita-ble for free tissue transfer flaps e. The cervicofacial flap is useful in such situations because of the excellent color and texture match of the surrounding neck and lateral face skin used in the reconstruction . The orbital defect was closed with no significant contour deformity. Thank you. Hufschmidt K, Bozec A, Camuzard O, et al. Cervicofacial flaps (anterior or posterior based),33–35 malar-posterior auricular-cervico flaps,36 advancement perforator cheek flaps,37 and free flaps38,39 have been used in the repair of large-sized defects. If you scrub in only to close: Axial flap CPT Codes. Using local and regional tissue has the advantage of a good color match and a One of the most useful reconstructive techniques in repairing cheek defects is the cervicofacial (CF) flap. J Oral Maxillofac Surg 2017. A subcutaneous flap is elevated from the chest. ventional cervicofacial flap, with the pecto-ral portion raised in a subcutaneous plane. (3). Methods. The CF flap offers an excellent texture and color match with the recipient area. Cervicofacial advancement-rotation flap in midface reconstruction: forward or reverse? Otolaryngol Head Neck Surg 2011;144:196–200. The combination of cervicofacial rotation flap and TMF. The defect was repaired with a rotational advancement flap with total primary and secondary defect area of 4. your surgeon is doing a 2 stage paramedian forehead flap. For large medial cheek-skin defects, we used a derived posterior-based cervicofacial flap, or cervical-medial cheek flap (CMCF). Nonmelanoma skin cancer (NMSC) is the most common type of skin cancer in the United States In cervicofacial defects, the skin paddle must be rotated 180° at its base to place the skin paddle externally. 7 cm squamous cell carcinoma from the right ear and a 1. This article The cervicofacial flap in facial reconstruction Joseph I. if > 30cm2: 14300 *Paramedian forehead flap: 15731 *Takedown of paramedian forehead flap . These rotation advancement flaps should be a staple of the head and neck surgeon's reconstructive armamentarium. 9 Beare expanded on this flap as an alternative for closing orbital exenteration defects. For the patient on the left, the vertical Advancement flap Unipedicle Bipedicle H-plasty T-plasty Cervicofacial advancement flap KEY POINTS A mastery of advancement flap design, selection, and execution greatly aids the surgeon in solving reconstructive dilemmas. The TMF was rotated and advanced to replenish the orbital defect, and the cervicofacial flap was raised. Grafts, like split-thickness skin or mucosal grafts, serve as non-vascularized tissue patches. If you haven't taken the time to master the CPT ® 2018 code changes for pedicle-flap repairs, you could already be to losing big pay. These codes 140xx-14xxx do not specify tissue type. CPT Guidelines for Tissue Flap and Graft Procedures Objective: To present the authors' experience and outcomes in the reconstruction of midfacial defects using cervicofacial advancement-rotation flaps (CARFs) based on a method of determining forward or reverse design in relation to the proportions of the defect. The cervicofacial flap is the mainstay of reconstruction for medium- and large-sized cheek defects. A. One of the most effective options is the cervicofacial flap (CF), which uses a random advancement and rotation flap technique based on the skin laxity of the cheek, preauricular region, and neck. CPT code 15733 Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae) The new edits bundle the following CPT codes with these two surgical codes. 3 Figure 16a: Cervical skin defect; flap has been based on the 1 st 3 perforators. 1 An inferior-to-superior V-Y advancement flap has also been described and has not been found to pose an elevated risk of The technique of cervicofacial rhytidectomy with short flap, facial superficial musculoaponeurotic system (SMAS) imbrication, cervical SMAS plication, inconspicuous incisions, and postauricular z-plasty allows for successful and sustainable results over time, with short recovery time and minimal com As reported by Juri in 1979, a cervicofacial flap is a highly useful option compared to other skin reconstruction methods because it allows the simultaneous use of the skin from the neck and the cheek. Cervicofacial flap : revisted - Download as a PDF or view online for free. Direct closure, even for large defects, often provides the most ideal result. cervicofacial flap is a highly useful option compared to other skin reconstruction methods because it allows the simultane-ous use of the skin from the neck and the cheek. B. Deep plane dissection has been advocated to decrease complication rates and improve results. 19 Large medial cheek cutaneous defects repair can be accomplished with local flaps that exhibit both pivotal and advancement movement to maximize the transfer of skin from the region of the posterior cheek and superior neck such as the cervicofacial flap (Fig. This necessitates the use of grafts or flaps. A) Schematic diagram; B) Flap design for two patients with large pre- auricular defect; C) Coverage of large pre-auricular defects with cervicofacial rotation flaps. Li The cervicofacial flap has been described for the reconstruction of larger (>4 cm), full-thickness defects of the cheek. • The flap can be anteriorly or posteriorly based. Advancement flaps are subcategorized as unipedicle, bipedic *Pec Flap: 15734 *TPFF, or temporalis muscle flap, or . Flap is used to fill in nearby or local defect. Obviously it denotes it can be from anywhere of the same tissue type so long as it maintains its vascular supply and tissue type but not from the immediate adjacent tissue- adjacent immediate to the margin of the closure area. Cervicofacial rotation flap cpt Xandy - double anal penetration. CPT 15738 refers to the surgical procedure involving the creation of a muscle, myocutaneous, or fasciocutaneous flap from the lower extremity of a patient. Boyette JR, Vural E. Subdivisions to the cheek unit have been proposed in treatment algorithms. Hand Surgery Flap CPT Codes. Figure 16d: Fully elevated cervicodeltopectoral flap. not make it a flap. Article PubMed Google Scholar Boyette JR, Vural E. Figure 16c: Elevate DP flap deep to pectoralis fascia. CPT 15829 refers to a specific type of rhytidectomy, commonly known as a facelift, which involves the use of a superficial musculoaponeurotic system (SMAS) flap. 1 Defects of the cheek region are therefore conspicuous and potentially difficult to reconstruct with minimal These flaps are insufficient for the closure of large and distant defects due to small flap sizes and rotational arcs (Table 1). This chapter focuses on local flaps used in surgical management of cutaneous squamous (SCC) and basal cell carcinoma (BCC) of the face. 10 Mustarde described utilizing an advancement and rotational flap for lower lid The literature is rich in algorithms for cheek reconstruction. Secretary in skirt getting her pussy fucked facial on the desk in the offic. Yasmin fonthys gaping hole and pissing. e6. CPT 15570 describes the formation of a direct or tubed pedicle of the trunk, with or without transfer. For the past several years, it has been the flap of choice for the reconstruction of facial defects especially cheek defects. Advantages of Cervicofial flaps : Operative time is short. Methods: We present a retrospective review of cases treated at a university-based cancer center. 2708. The flap can be used alone or in combination with regional and free flaps depending on the extent of the defect. thus allows exposure of the parotid gland and the neck structures in preparation for parotidectomy and/or neck dissection if these are Microvascular and Free Flaps. Muscle, myocutaneous, or fasciocutaneous flap; trunk (15734) Muscle, myocutaneous, or fasciocutaneous flap; upper extremity (15736) Muscle, myocutaneous, or fasciocutaneous flap; lower extremity (15738) Flap; island pedicle (15740) Flap; neurovascular pedicle (15750) American Society for Surgery of the Hand Per CPT (professional edition) instructions, for codes 14000 - 14302, "the primary defect resulting from the excision and the secondary defect from flap design to perform the reconstruction are measured together to determine the code. This rotation must be performed loosely so that no kinking of the vessels occurs. CPT code 15733 is used when a reconstructive flap is necessary to cover a defect in the head and neck region. Cervicofacial flap : revisted. In contrast, flaps are vascularized, contributing to high success reconstructed with a rhomboid flap, which includes a portion of the nasalis muscle. Figure 16b: Incise skin, fat, and pectoralis fascia. There are numerous reconstructive options for cheek defects, such as primary closure, skin grafting, healing by secondary intention, and local, regional, or free flaps. Setting: Tertiary care academic medical center. Kundan Singh. A transposition flap is cut, lifted, and transferred over intervening tissue onto the CPT 15620 refers to the surgical procedure of delaying a flap or sectioning a flap, specifically involving the division and inset of a pedicled flap at various anatomical locations such as the forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet. With two new codes, one deleted code, and a few new CPT ® text notes in the "Flaps (Skin and/or Deep Tissues)" section, we have the expert advice you need to make sure you stay on Other than the FESS CPT® changes for 2018, there are changes to Flaps (skin and/or deep tissues). Cervicofacial advancement-rotation flap in midface reconstruction: forward or reverse? Otolaryngol Head Neck Surg Fasciocutaneous Flaps, on the other hand, describe the type of tissue flaps and do not describe advancement flaps for closure. Types of Tissue Transfer • Rhombi • Bilobed or nasolabial fold flap • advancement flap We will code CPT 14301 x1 for the first 60 sq cm of repair and then CPT 14302 x2 for the remaining 40 These are commonly referred to as "local flaps" since tissue near or local to the defect is moved on to it. Helman, DMD Department of Oral and Maxillofacial Surgery, University of Michigan School of Dentistry, Taubman Center Room B1-210, University Hospital, Ann Arbor, MI 48109-0018, USA Extensive defects of Key points • The cervicofacial flap is a random pattern flap. The cervicofacial flap is more superior in terms of the ease of elevation, excellent skin color, and texture match, and also, the donor site can be closed simultaneously. INTRODUCTION. The design of the CF flap varies between different cheek subunits. e. Study design: Case series with retrospective chart review. Versatility of cervicofacial flaps: Cervical-medial cheek flap for reconstruction in cutaneous substance loss of the inner cheek. The muscle was then closed with multiple interrupted Vicryl sutures. D. In this report, the authors review their experience with this flap and present a guide for flap design for different cheek subunits. Select. 10 Mustarde described utilizing an advancement and rotational flap for lower lid . SCM rotational flap: (all have same code) 15732 *Cervico-facial rotational/advancement flap: if <10 cm2: 14060 . Subscribe to Codify by AAPC and get the code details in a flash. Conventional teaching recommends cervicofacial rotation-advancement flaps for the reconstruction of lid-cheek junction defects in order to minimize inferior tension on the lower eyelid and reduce the risk of ectropion. e1-6. Smaller defects of the cheek may be closed by elevation and advancement of the circumferential skin. The cervicofacial flap is categorized as both an advancement and rotational flap based on a random blood supply. J Oral Maxillofac Surg 2017;75:2708. 0 sq cm (14021) Hi, I'm not sure how to code these. It is important to note that this code should be used in conjunction with other codes that describe the primary defect being repaired. Performing flap elevation deep to the superficial musculoaponeurotic system (SMAS) has been shown to result in less skin flap necrosis compared to subcutaneous flap elevation. 5 cm squamous cell carcinoma from the right cheek. Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less (14000) Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less (14020) Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10. [Google Scholar] [26]. The cervicothoracic flap can be extended inferiorly to the costal margin, but most recommend not extending the flap beyond the nipple. If the flap stretches to reach the defect, tension The Current Procedural Terminology (CPT ®) code 15620 as maintained by American Medical Association, is a medical procedural code under the range - Flaps (Skin and/or Deep Tissues) Procedures. • The cervicofacial flap is an excellent option for medium- and large-sized cutaneous cheek defects. Introduction: nature of the problem There are numerous My physician excised a malignant skin lesion from the left cheek measuring 2. The cheek is the widest skin expanse of the face and is an important cosmetic and functional unit that provides a platform for crucial midface structures while supporting the lips, nose, and lower eyelids. When adjacent tissue transfer is performed for a single defect at any anatomic site and the defect is larger than 30 sq cm, report CPT 14301 for the first 60 sq cm and 1 unit of As it is a thin flap, additional bulk may be provided with a pectoralis major muscle flap placed deep to the cervicofacial flap. 15732 Myocutaneous flap 11641 Wide excision of basal cell 12051 Closure of flap donor site This procedure has been upcoded and unbundled. The CF flap is a random-pattern flap that provides excellent skin color, thickness, and texture The presentations are short and meant to generate awareness of the guidelines that are available in CPT rather than the application of guidelines to specific coding scenarios. Debridement / Recipient site preparation; Z / W Plasty Etc; Cross / Fillet Finger; Form / Delay / Section Pedicle; Axial; Free When conventional wound closure methods, whether for cosmetic or functional reasons, prove impractical, the need arises for additional tissue reconstruction. Cervicofacial Flap in Cheek Reconstruction. They can be posteriorly or anteriorly based and can be elevated in a subcutaneous or sub-superficial musculoaponeurotic system (SMAS) plane. Advancement flapsinvolvecarefully plannedincisions tomost efficientlyclose aprimary defectin a linear vector. A rotation flap is a curvilinear flap that closes a defect by a rotating the skin around a pivot point. org KEYWORDS Cervicofacial flap Maxillofacial surgery Cheek defects Temporofrontal defects Brow defects Chapter 13 Cervicofacial advancement flap Introduction. By using nearby tissue, flaps permit excellent skin color, texture, and thickness matching the For large cheek defects, distant flaps such as cervicofacial, cervicopectoral, deltopectoral, and pectoralis major myocutaneous flaps are excellent choices. Anteriorly based flaps are used to cover defects of the anterior and superior cheek, whereas posteriorly based flaps can be used to cover the anterior and A mastery of advancement flap design, selection, and execution greatly aids the surgeon in solving reconstructive dilemmas. Dec 12, 2018 Download as PPTX, PDF 3 likes 1,107 views. 0 cm. 0 sq cm (14021) *Pec Flap: 15734 *TPFF, or temporalis muscle flap, or . CPT Code 15570. Flaps can reduce and redirect tension, making them indispensable tools in wound closure. In a properly designed flap, incision and undermining are generally complete when the flap can be laid over the primary defect and be in full contact with the lower lid portion of the defect before placing a single suture (Figure 3). Check location and combined areas to capture separately reportable procedures. 75 sq cm. 2). DOI PubMed. 1 Esser first described using a rotational cheek flap for closing defects in 1918. E-mail address: Anastasios. Cat seaborne a slut for hire. The name cervicofacial flap was first used by Kaplan in 1978 in a report of the versatility of this flap for the coverage of defects following the removal of cancer of the head and neck. No CPT guidance or other direction specifically limits these codes to skin and or subcutaneous tissue. AMA CPT ® Assistant - 2010 Issue 3 (March) Pedicle Flaps (Skin and/or Deep Tissues) - (Codes 15570-15576) (March 2010) March 2010 pages 4-5 Pedicle Flaps (Skin and/or Deep Tissues) - (Codes 15570-15576) A pedicle flap is a segment of tissue transferred to fill a defect while maintaining its own original blood supply. This procedure involves the transfer of a free fascial flap, which consists of skin, underlying fascial tissue, and blood vessels, from a donor site to a recipient site. A portion of the flap is left intact to supply blood to the grafted area. A standing 4:34 _____ deformity was taken off over the surface of the chin and right lateral limb of the Karapandzic flap, in addition. Result 2 months postoperatively. J Oral Maxillofac Surg 2017; 75 (12): 2708. By Ken Camilleis, CPC, CPC-I, CMRS An adjacent tissue transfer (CPT ® 14000-14350) relocates a flap of healthy skin from a donor site to an adjacent laceration, scar, or other discontinuity. Case 7: Nasalis muscle based flap A)CPT® 14060, adjacent tissue rearrangement, nose, ≤ 10 sqcm B)CPT® 15740, flap, island pedicle C)CPT® 15732, muscle, myocutaneous, or fasciocutaneousflap, head and neck 6 days post-op Case 7: Answer The nasalis muscle flap is really an island advancement or V-Y flap. This flap can be used for defects of the cheek, temple, and orbit. As reported by Juri in 1979, a cervicofacial flap is a highly useful option compared to other skin reconstruction methods because it allows the simultaneous use of the skin from the neck and the cheek. A flap is used when more straightforward closure techniques, such as secondary intention, primary closure, or skin grafting, produce a functionally or cosmetically unacceptable result. CPT Code 15572. Please advise. The procedure involves transferring healthy tissue from the lower leg or thigh to the affected area, ensuring that the The cervicofacial flap is a workhorse flap in the reconstruction of unilateral defects affecting the cheek. It provides a large surface area with excellent color and texture match. 14 We prefer to raise the Below is a list summarizing the CPT codes for flaps (skin and/or deep tissues) procedures. if 10-30 cm2: 14061 . When comparing outcomes of the cervico-thoracic and the conventional cervicofacial flap, Moore Secondly, multiple interrupted 3-0 Vicryl sutures were placed from the deep margins of these advancement flaps to the underlying deep subcutaneous tissues at multiple points along the length of both of the advancement flaps in a manner so as to advance the soft tissue flaps towards one another and to distribute the tension along the length of the soft Local flap surgery is commonly performed to cover defects with appropriate skin color and texture match. Superiorly it can reach the supraorbital margin, laterally the postauricular Per CPT® Assistant July 2008, Volume 18: Issue 7, Coding Communication, Adjacent tissue transfer or rearrangement procedures (local The cervicofacial flap has a wide pedicle and can be employed to cover large antero-lateral craniofacial defects. 1 However, the size and location of defects are variable, sometimes too large to 20 The Open Otorhinolaryngology Journal, 2011, Volume 5 Bokhari and Wang (A) (B) (C) Fig. CPT CPT 15758 refers to the procedure of free fascial flap with microvascular anastomosis, a sophisticated surgical technique utilized in reconstructive surgery. Sakellariou@bmc. This procedure is a critical component in reconstructive surgery, allowing for the effective closure of defects while One of the most useful reconstructive techniques in repairing cheek defects is the cervicofacial (CF) flap. Amazing boy gets great head in workshop part2. Stage 1 (previously performed) would have been coded with CPT code 15731 for forehead flap with preservation of va [ Read More ] The cervicofacial flap was first described in 1969. CPT Code 15630, Surgical Repair (Closure) Procedures on the Integumentary System, Flaps (Skin and/or Deep Tissues) Procedures - Codify by AAPC. presence and position of facial scarring are less important in the peripheral units. A properly designed and Focus on vascular pedicle to choose correct code. This technique is primarily utilized to treat injuries or open wounds in areas requiring reconstruction. Cervicofacial advancement flaps can be performed under intravenous sedation with very low complication The cervicofacial flap in cheek reconstruction: a guide for flap design. Just because a flap includes muscle tissue does not qualify it as a muscle or myocutaneous flap to be reported with code 15732. , zygo-maticofacial flap] with preservation of vas-cular pedicle(s)) is a new code developed in conjunction with ophthalmology to describe what is This article explores the CPT codes associated with various other flaps and grafts procedures, detailing their specific applications and documentation requirements. This surgical procedure is designed to remove excess skin and fat from the face, thereby tightening the skin and reducing the appearance of wrinkles. CPT 15620 describes the delay or sectioning of a flap at the forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet. For this reason, a rotational flap can be more suitable for this area than is a V-Y advancement flap. " This isn't like free grafts, where the code is determined by the size of the recipient area alone. Technique for repair of Zone 2 cheek defects. The provider creates a muscle, myocutaneous, or fasciocutaneous flap from an upper extremity of the patient to treat an injury or open wound on an affected area. CPT 15610 describes the flap delay or sectioning of the flap (division and inset) at the scalp, arms, or legs. pedicle (2 nd stage) 15630 . If you scrub in only to close: cervicofacial and cervicothoracic rotation flaps The above series illustrates the reconstruction of a large cervical cutaneous defect. Submit Search. 1, 2 In 1985, Jackson reported the use of a similar skin flap as a lateral cheek rotation flap. e1–2708. Muscle or myocutaneous free flap (microvascular transfer) (15756) Free skin flap (microvascular transfer) (15757) Free fascia flap (microvascular transfer) (15758) Bone graft with microvascular anastomosis; fibula (20955) Bone graft with microvascular anastomosis; metatarsal (20956) Summary There are three anatomic zones, the suborbital, preauricular, and buccomandibular (zones 1, 2 and 3, respectively), to consider when reconstructing the cheek. Superiorly it can reach the supraorbital margin, laterally the postauricular New CPT 15730 (midface flap [i. Over a The flap also allows adequate exposure of the CF structures for Oral and Maxillofacial Surgery Department, Boston University, 100 East Newton Street, Boston, MA 02118, USA * Corresponding author. " pre-op chin tissue and the Karapandzic flap medially. elderly or medically unfit patients who Local flap CPT Codes. 3 We experienced a case of a patient with squamous cell carcinoma (SCC) of the Extensive defects of the face may require distant flaps (eg, pectoralis major myocutaneous flap, deltopectoral flap, forehead flap) or free tissue transfer. The Cervicofacial Flap In Cheek Reconstruction: A Guide For Flap Design. 1,2 In 1985, Jackson reported the use of a similar skin flap as a lateral cheek rotation flap. Patient characteristics, surgical technique, and complication rates are described. The cervicofacial flap, an extended version of Mustarde’s rotation flap , has been described for the reconstruction of midface soft tissue defects especially on cheek, temple and inferior eyelid . Tweet. In its place, two new codes, 15730 and 15733 were established to replace the one code, 15732 to clarify reporting of myocutaneous and The cervicofacial flap has a wide pedicle and can be employed to cover large anterolateral craniofacial defects. g. • The cervicopectoral flap can be used in very large cheek defects. Local flap CPT Codes. . Modifications extending to the chest when necessary have been documented. However, the subcutaneous approach is still widely used. The sternal, costal, and humeral attachments of the pectoralis myofascial flap are divided and the flap is rotated for soft tissue coverage of the carotid artery. The cervicofacial (CF) flap is a random-pattern flap that provides an excellent match for cheek reconstruction. This installment of the series explores the guidelines related to CPT coding for tissue flap and graft procedures. jpdcxxhobufdkejnemxxqyrlhqklijsuiswaypsnryocmyuvlqugdoqryquzfjfyhavvqdyfq