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Sternal reconstruction and bilateral pectoralis major advancement flaps

Date: Feb 8, 2023

Question:

Can you please help with this one? Dissection was carried down to the sternum, which the entire length was a severe nonunion. The oscillating sternal saw was used to complete a re-do sternotomy. The xiphoid process was removed d/t very protuberant and causing pain. We then developed bilateral pectoralis major advancement flaps by developing a plane beneath the LT and RT pectoralis major muscles. Each muscle was lifted off the sternum and mobilized toward the midline. Ostectomy was performed to freshen the edges of the sternum. I used the KLS plating system. Reduction clamps were used to bring sternum together and for allowing placement of plates and were removed. The flaps were then closed over the midline using #1 PDS suture. Drains were placed and layered closure was performed. Would this be coed as 21750 and 14000 vs 15734 x 2? we are unsure on the muscle advancement flap codes. Thank you.

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