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14301 billing right and left

Victoria Posted Mon 21st of October, 2019 16:44:19 PM
is code 14301 billed as right and left during the same surgery?
SuperCoder Answered Tue 22nd of October, 2019 08:06:28 AM

Hi,

Thanks for your question.

In an adjacent tissue transfer (ATT) the physician transfers a skin part to another skin segment.  The CPT code 14301 is for an ATT any area with defect of 30.1 to 60.0 sq CM in size as total combined area, then CPT code 14302 for each additional 30.0 sq CM area can be used.

Modifier RT and LT can be appended with 14301.

Hope this helps.

Thanks.

Victoria Posted Tue 22nd of October, 2019 09:11:53 AM
What if the physician is doing the skin transfer bilaterally during a breast reconstructive surgery. Is it appropriate to bill the code twice with RT or LT?
SuperCoder Answered Wed 23rd of October, 2019 07:39:21 AM

Hi,

Breast reconstruction is a surgical procedure designed to recreate a breast mound following a mastectomy performed to treat cancer or other disease, or a mastectomy performed for prophylactic purposes. Reconstruction can be accomplished by using a prosthesis (implant) or the patient's own (autogenous) tissue, such as a flap of muscle with or without overlying skin, that is moved from its native site and transferred to the breast area recipient site. In some cases, a combination of both may be used. The reconstructed breast is sized and contoured to match, as closely as possible, the remaining breast. Occasionally the remaining breast may also require surgical contouring.

As per AHA HCPCS coding clinic article, a patient opted for breast reconstruction after bilateral mastectomies will assign code 14301 for skin flaps and excision of the previous scars in order to repair the bilateral chest defects with no mention of modifier RT and LT.

Please find below link for the article.

https://www.supercoder.com/hcpcs_coding_clinic/codingclinic_hcpcs_details/690

If you are unable to open the article, kindly let us know. We will provide you with the document.

Hope this helps.

Thanks.

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