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Denial of CPT Code for Medicare

Lisa Posted Fri 27th of March, 2020 09:45:11 AM
I am trying to see why Medicare would deny CPT code 14041 as included in another payment but it was billed by itself. This is for ENT.
SuperCoder Answered Mon 30th of March, 2020 07:26:18 AM

Hello Lisa,

Thank you for your question.

 

As per CPT Guidelines, codes 14000-14302 are used for excision (including lesion) and/or repair by adjacent tissue transfer or rearrangement (eg, Z-plasty, W-plasty, V-Y plasty, rotation flap, random island flap, advancement flap). When applied in repairing lacerations, the procedures listed must be performed by the surgeon to accomplish the repair. They do not apply to direct closure or rearrangement of traumatic wounds incidentally resulting in these configurations. Undermining alone of adjacent tissues to achieve closure, without additional incisions, does not constitute adjacent tissue transfer, see complex repair codes 13100-13160. The excision of a benign lesion (11400-11446) or a malignant lesion (11600-11646) is not separately reportable with codes 14000-14302.

 

Adjacent tissue transfer or rearrangement codes are anatomical area and defect size specific codes, so reporting an anatomical area code with defect size will be appropriate. Example: for ATT at nose and ear area, appropriate code will be 14060 (Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less).

 

Kindly share the reason for your denial of CPT® code 14041. Also, provide us with other codes, if billed on the same day. It will help us determining the actual coding denial.

 

Hope that helps!

Thanks

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