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luisa Posted 1 Year(s) ago
Physician would like to know if this is the correct code.14021 dx:left forearm volar open wound with soft tissue necrosis. Px: left forearm adjacent tissue transfer 120 cm2 Approximately silver dollar sized area of full thickness skin loss was marked circumferentially.
SuperCoder Posted 1 Year(s) ago

As per ATT coding guidelines, codes are categorised as Size (in Sq. Cm) and Location of defect (Recipient Site).

If the size of left forearm adjacent tissue transfer is 120 cm2, then you can code 14021, 14301,14302X2, for your scenario.

luisa Posted 1 Year(s) ago
Thank you for your immediate response. Will you show me how did you come up with your calculations?
luisa Posted 1 Year(s) ago
Thank you for your immediate response. Will you show me how did you come up with your calculations?
luisa Posted 1 Year(s) ago
also 14021 & 14301 hits a NCCI edit. they both cant be coded together.
SuperCoder Posted 1 Year(s) ago

CPT code 14021 is for defect 10.1 sq cm to 30.0 sq cm = 14021 (1 UNIT)

14301 is for defect 30.1 sq cm to 60.0 sq cm; 14301 (1 UNIT)

14302 is for each additional 30.0 sq cm, or part thereof = 14302 (2 UNITS)

Total size is 120 sq cm; hence, adding 30 sq cm from each code, gives a total size of 120 sq cm.

So, the billing would be 14021X1 unit

                                      14301X1 unit

                                      14302X2 units

To rule out the CCI edit; append modifier-59 with CPT code 14021.

 

NOTE: CPT code 14021 is the only code available for “arm”” with defect size 10.1 sq cm to 30.0 sq cm.

CPT code 14302 is an add-on for additional 30.0 sq cm, or part thereof; hence, it will require a primary code. Primary code for 14302 is 14301.

Posted by luisa, 1 Year(s). There are 6 posts. The latest reply is from SuperCoder.

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