Wiki Coding Partial Mastectomy and adjacent tissue transfer

[WendyHunter]

I have done a lot of reading and I can't positively verify if you can code the adjacent tissue transfer when done along with a partial mastectomy. The doctor was even specific on the dimensions. But I read in a couple articles that closure techniques were included in the procedure 19301.

 

[Kellyg45]

I code these 2 codes together & I get a lot of denials. Even after they are appealed they say the documentation doesn't support the 14001, even though it is clearly documented. Sometimes they say it is included in the 19301. Any suggestions on how you are getting it paid? Thanks.

 

[fwnewbie]

The way I understand it, when the surgeon is repairing the incision, the repair is included. If the repair is done as a procedure to correct an existing defect then the adjacent tissue transfer can be used.

 

[Shweta]

It is not appropriate to report either code 14000, Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less, or 14001, Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm, in addition to code 19301 because simple, intermediate, and complex layered closure is included in the work represented by code 19301.

 

[such78]

Question:

Is it appropriate to report Current Procedural Terminology (CPT®) code 14000 or 14001 for a subcutaneous advancement flap for closure after a lumpectomy (or partial mastectomy)?

Answer:

No, it is not appropriate to report either code 14000, Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less, or 14001, Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm, in addition to code 19301, Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy), because simple, intermediate, and complex layered closure is included in the work represented by code 19301.