Outpatient Facility Coding Alert
Code 14040 Suffices for Lesion Removal and Tissue Transfer
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Question: The dermatologist performed an adjacent tissue transfer. Should I also code for the associated lesion removal?
Florida Subscriber
Answer: Unlike intermediate or complex closures, you cannot report lesion removal if the dermatologist performed adjacent tissue transfer, because the tissue transfer is part of the lesion removal. The dermatologist performs an adjacent tissue transfer after the scar is excised and debrided,
As the adjacent tissue transfer includes repair, don’t code separately for repair.
You should code the tissue transfer procedure as 14040 (Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less) or 14041 (... defect 10.1 sq cm to 30.0 sq cm).
Like the repair codes, size (in square centimeters) and the location of the defect determine the adjacent tissue transfer codes. However, when coding a defect that is more than 30 sq cm, report 14301 (Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm) and, if necessary, +14302 (Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof [List separately in addition to code for primary procedure]) regardless of the location on the body.
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