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Otolaryngology Coding Alert

Reader Question:

Don't Report Excision With Tissue Transfer

Published on Fri Oct 01, 2004

Question: Does an excision code include reconstruction? For instance, when an otolaryngologist excises a lesion (11640) and performs rotational flap reconstruction (14060), should I report both procedures?

Florida Subscriber Answer: Actually, the reverse is true: The reconstruction code includes the excision.

Therefore, in your example, you should report only 14060 (Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less). CPT instructs that the adjacent tissue transfer (14060) includes lesion excision (11640, Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less) because it is site prep.

Watch out: Free grafts, split thickness grafts, pedicle flaps, intermediate and complex closures don't include excision.
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