Advance tissue Rearrangement


Best answers
Hoping someone can give opinion on below

A physician wants to perform lesion removals and perform adjacent tissue rearrangement.
I am aware documentation must support 2 separate incisions/defects.

My question is, can ATR be billed for lesions under 1cm? Is there a "minimal" requirement?

I have research this and can not find anything. Some of these are lesions of .5cm and less.

Any help would be greatly appreciated.


True Blue
Best answers
The excision of the lesion is included in all ATR codes, regardless of the size of the lesion removed, so if the physician is using ATR as the method of closure, you would only bill the ATR code, never the excision (unless an excision was performed on a separate lesion at the same session, which would support the modifier 59). The is no requirement that I know of that the lesion exceed a certain size in order to support the adjacent tissue method, however I'd urge the physician to document medical necessity for this type of closure, especially if the lesion is small. This is a high dollar procedure which is typically used for closure when the lesion is large or in a particular anatomical location where an intermediate or complex closure is not possible. If the physician is using ATR with high frequency or routinely for small lesions or in locations where a less complex procedure would be more appropriate, then they could show up as an outlier in the usage of these codes and you could potentially run into audits that might question the medical necessity of this level of care.