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General Surgery Coding Alert

Reader Question:

Include Lesion Excision In Tissue Transfer

Published on Tue Dec 18, 2012

Question: Our surgeon excised a carcinoma of the face. He closed the excision using adjacent tissue transfer. Can I report 14040
and 11643? Tennessee Subscriber Answer: No. You should report 14040 (Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; defect 10 sq. cm or less) for the closure using existing tissue transfer. In this case, you should report 14040 only. The lesion excision (11643, Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm) is included in the tissue transfer. Exception: There is one exception to this coding scenario. If your surgeon performed the excision on a separate (earlier) day from the tissue transfer, you may report the procedures separately. This may have occurred, for example, if the doctor wanted to wait for the pathology report to be sure the margins are clear before closing [...]
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