Coding guidelines for Tissue Transfer or Rearrangement

Coding guidelines for Tissue Transfer or Rearrangement 

 ATT

ATT Definition:

        Flap is used to fill in nearby or local defect.

Types of Tissue Transfer

•      Rhombi

•      Bilobed or nasolabial fold flap

•      advancement flap

•      V-Y repair or flap

•      Rotation flap

•      Random Island Flap

•      W-plasty

Z-plasty

  ATT

Coding guidelines

•      Do not report codes 11400-11446 or 11600-11646 for excision of benign or malignant skin lesions at the site of adjacent tissue transfer.

•      Code is based on the total square centimeters of area repaired with adjacent tissue transfer techniques

Calculation of cm

When coding adjacent tissue transfer, the term “defect” refers to the primary defect (the area needing repair in the first place) and the secondary defect (any defect created by the effort of designing and mobilizing a flap) together. Add together the total square centimetres of the primary and secondary defect areas to get your total area for repair

 Example:

 Documentation stated that laceration on leg  was 8cm x3cm

multiply 8 x3 to arrive at 24 square centimeters of area for my adjacent tissue transfer code.

Two separate area  (two areas that are not touching and have distinct margins) fall under same range of CPT code for the defect 30 or less than should be coded separately for each site with 59 modifier.

              Eg If the surgeon perform v-y plasty on foot 5×3. and neck 6×2

                     14041 (15cm) , 14041 (12cm)-59

For more than 30sqcm

•      “Any anatomic area” with an adjacent tissue transfer greater than 30 sq cm. We will code CPT 14301 x1 for the first 60 sq cm of repair and then CPT 14302 x2 for the remaining 40 sq cm of repair.