As you probably know from this issue, there is a Coding Clinic citation that reads:
Fat excision for grafting to fill an acquired defect
Coding Clinic, Third Quarter 1992 Page: 13
Effective with discharges: July 1. 1992
How do you code excision of fat from the abdomen for grafting to the sphenoid sinus following the partial transsphenoidal removal of a hemorrhagic pituitary tumor?
Assign code 07.62, Partial excision of pituitary gland, transsphenoidal approach, for the procedure performed.
In accordance with Coding Clinic, Second Quarter, 1998, p. 20, it is appropriate to assign code
86.89, Other repair and reconstruction of skin and subcutaneous tissue, for a fat graft.
But this has been superseded and the remedial answer is:
"An additional code would not be assigned for any excision of fat, muscle, or cartilage used to fill a void."
In other words, the advice is NOT to assign the code. And, if you don't, it's back to where it should be.
Then, unfortunately, someone asked the question again and we got:
Clarification - fat graft Coding Clinic, First Quarter 2000 Page: 26
Effective with discharges: April 1, 2000
Clarification, Fat Graft
When fat is harvested and used to fill a void during surgery, is it appropriate to assign code 86.89, Other repair and reconstruction of skin and subcutaneous tissue?
It is appropriate to assign code 86.89, Other repair and reconstruction of skin and subcutaneous tissue, for a fat graft. This is consistent with advice previously published in Coding Clinic, Second Quarter 1998, p. 20, which supersedes advice published in Coding Clinic, Third Quarter 1992, p. 13.
In other words, they superseded their superseding by going back to where they were in the first place. I would NOT assign the code for filling the void with fat at all. This has to go to Coding Clinic and CMS.