Health data standards and systems

A patient was admitted to this hospital for closure of an oro-antral communication. The oro-antral communication was closed using a buccal advancement flap.

I note the following ACHI index entries:
Flap, advancement - see Flap/skin
Flap, buccinator - see Flap/myocutaneous
Flap, mouth
Flap, mucosa, mucosal - see also Flap/skin
Flap, oronasal fistula

There is no ACHI index entry under flap for buccal.
We also note that in the ACHI Tabular Chapter 16, skin and subcutaneous tissue includes mucous membranes.

Can the committee please advise:
What code should be assigned for a buccal advancement flap for closure of an oro-antral communication?
What code should be assigned for a buccal flap/buccal advancement, not otherwise specified? (i.e. not used for closure of an oro-antral communication).

VICC considers oro-antral communication to be synonymous with oro-antral fistula, based on IHPA Coding Rule Q3344 Intraoperative oroantral fistula resulting from tooth removal, which defines oroantral fistula as “a persistent open communication”.

Therefore, for a buccal advancement flap for closure of an oro-antral communication, VICC advises to assign 41722-00 [388] Closure of oro-antral fistula only, following ACHI Index entry Closure/ fistula /oro-antral (closure) (plastic).

For buccal flap or buccal advancement flap without further specification of the type or site, VICC advises that as the term buccal refers to the cheeks or mouth cavity, 45206-02 [1651] Local skin flap of lip should be assigned following ACHI Index entry Flap/skin (local) (single stage) NEC/mouth. Notwithstanding the code descriptor of ‘lip’ in the code title, VICC considers this the correct code to assign as per the Index entry and the includes note of ‘mouth’.