Adjacent Tissue Transfer

[Texascoder64]

can anyone tell me if you do an excesively large flap say on the face and is 90 sq cm would you NOT use the 14041 - and go directly to the "any area" 14301, 14302 and use just 14301,14302?

Thank you!

 

[nsteinhauser]

That is correct. Here is an example from CPT Assistant July 2008 that shows that scenario. Of course the split thickness autograft below doesn't apply in your situation and the 14300 is discontinued now - you would use 14301 or 14302.

Example 2

A 6 cm malignant lesion with 0.5 cm margins and a 7 cm excised diameter is excised from the neck. A transposition flap is used to close the 50 sq cm defect. The flap donor site is partially closed, but there is a remaining 10 sq cm defect, which requires a split-thickness skin graft:

14300 Adjacent tissue transfer

15120 51 Split-thickness autograft

The lesion excision is included in the adjacent tissue transfer code and is not coded separately. The skin graft necessary to close the flap donor site is coded in addition to the flap.

Note that modifier51, Multiple Procedures, is appended to CPT code 15120 to indicate that multiple procedures were performed at the same session by the same physician. However, reporting practices related to these services may vary, and third-party payers should be consulted for their preferred method of reporting multiple procedures. Some payers may require the use of modifier 59.