Wiki Cpt 14301 twice?

[Kevinph84]

Hello Everyone,

I was wondering if someone could please help me with the below case? I have a question regarding the reporting for the below CPT codes.

14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm)

+14302 (Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure).

I have a plastic surgeon who removed two seperate epidermal inclusion cysts. One was located on the back. The other located on the forehead. The forehead's defect was repair using a rotational flap for a 32 sq cm. defect. The back was also repaired with a advancement flap with a total of 72 sq cm defect.

Since both are over 30 sq cm, you would look at CPT code 14301. Now should this case be coded with CPT codes 14301, 14301-59, and then 14302? Or would you add the measurements all together and report CPT codes 14301 and 14302 X 2.

I recall the capability of reporting advancement flaps by lesions performed. I know for simple, complex, and intermediate you calculate the defect size for all repairs and report based on type of closure and the location. For some reason I am drawing a complete blank on the rules for advancement flap reporting. I am not getting a clear cut answer from my coding resources.

Thank you all for your help!

 

[sajanamatya]

As per CPT Assistant, July 2000, page 10, if two lesions from the same anatomical classifications (e.g. forehead, neck etc) are removed and both of the created defects require ATT repairs, the ATTs may be reported for each tissue transfer performed, provided the defects have distinct margins and are not contiguous. Now in your example, defect repairs are done on two different groupings of anatomic sites (e.g. forehead and back). Hence, ATT codes should be reported separately (14301, 14301-59, 14302).

 

[Kevinph84]

Thank you for your help.