Three Tips to Achieve Proper Tissue Transfer Coding

Published: 08th December 2010
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Three Tips to Achieve Proper Tissue Transfer Coding

Tip: Do not count on separate lesion removal payment

When your dermatologist carries out a wound repair closure, you could be miscoding if you automatically turn to 12001-13160. You need to go deep into the surgeon's documentation to see if a tissue transfer code is more appropriate – however knowing the difference between wound repairs and tissue transfers is just the start. See to it that your surgeon gets the payments he deserves with three steps:

Get to know the difference between transfers and repairs

For wound closure procedures, you will first need to decide between wound repair codes 12001-13160 and adjacent tissue transfer codes 14000-14300 (Adjacent tissue transfer or rearrangement …).

The basics: In laymen terms, if your surgeon only cleans and sutures the wound you will choose a simple, intermediate or complex repair code (12001-13160). If your surgeon documents that he freed tissue from around the wound and rearranged it to cover and repair the wound area, you are dealing with a tissue transfer and need to turn to 14000-14300.

The wound repair/closure CPT codes 12001-13160 describe direct wound closure employing sutures, staples, or tissue adhesives (cyanoacrylate). The tissue transfer CPT codes 14000-14300 are used for the repair of traumatic wounds and for the excision of a lesion and the repair of the resulting ‘primary defect' by adjacent tissue transfer or rearrangement (including Z-plasty, W-Plasty, V-Y plasty, rotational flap, randon island flap, or advancement flap)."

Other types of flaps are reported in two other places in CPT:"Flaps (Skin and/or Deep Tissues)" (15570-15738) and "Other Flaps and Grafts" (15740-15776). Traumatic wounds that incidentally result in one of these configurations are not reported with these codes.

Determine overall area and location

Once you determine that your dermatologist carried out a tissue transfer, you will need to narrow down your code selection by determining the total area of the primary and secondary defects, as per CPT instructions.

After adding up the affected area, take a look at the repair's anatomical location to narrow your choices even further.

Skip separate lesion removal coding

You shouldn't report any lesion removals your surgeon carries out during a tissue transfer procedure. The excision of the benign lesion (CPT 11400-1446) is not separately reported with the tissue transfer codes (CPT 14000-14302). Both CPT and CMS/Correct Coding Initiative guidelines reinforce this guidance.

For more detailed information on this, sign up for a medical coding guide like Supercoder!

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