How To Use CPT Code 14060

CPT 14060 is a code for adjacent tissue transfer or rearrangement in the eyelids, nose, ears, and/or lips, covering defects of 10 sq cm or less. This article will discuss the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and provide examples of CPT 14060 procedures.

1. What is CPT 14060?

CPT 14060 is a medical billing code used to describe a specific type of surgical procedure involving the transfer or rearrangement of adjacent tissue in the eyelids, nose, ears, and/or lips. This code is applicable when the defect being treated is 10 square centimeters or less in size.

2. 14060 CPT code description

The official description of CPT code 14060 is: “Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider clearly demarcates the exact area of the defect on the skin.
3. Adjacent tissue transfers (ATT) are performed to cover lesions of the eyelids, ears, or lips by relocating a flap of adjacent normal, healthy tissue into the damaged area.
4. The provider carries out the excision of the area he has marked.
5. A flap from the adjacent healthy tissue is taken.
6. The provider fixes this flap into the area of primary or secondary integumentary defects, such as by sutures.
7. The provider ensures that the bleeding is stopped and applies a clean dressing.

4. Qualifying circumstances

Patients eligible to receive CPT code 14060 services are those with defects in the eyelids, nose, ears, and/or lips that require adjacent tissue transfer or rearrangement. The defect must be 10 square centimeters or less in size. This procedure is typically performed to treat skin cancer, trauma, or congenital defects.

5. When to use CPT code 14060

It is appropriate to bill the 14060 CPT code when a provider performs an adjacent tissue transfer or rearrangement procedure on a patient with a defect in the eyelids, nose, ears, and/or lips that is 10 square centimeters or less in size. This code should be used when the procedure involves the transfer of healthy tissue from an adjacent site to cover the defect.

6. Documentation requirements

To support a claim for CPT 14060, the following information should be documented:

• Patient’s medical history and physical examination findings
• Indication for the procedure, such as skin cancer, trauma, or congenital defect
• Size and location of the defect
• Details of the adjacent tissue transfer or rearrangement procedure, including the type of flap used and the method of fixation
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 14060, it is important to follow the appropriate guidelines and rules. Lesion removal should not be billed separately if the provider performs adjacent tissue transfer, as it is considered part of the tissue transfer. If a skin graft is necessary to close secondary defects, it should be billed as an additional procedure. The term “defect” in this context refers to both primary and secondary defects.

8. Historical information

CPT 14060 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 14060

Five similar codes to CPT 14060 and how they differentiate are:

1. CPT 14061: This code is used for adjacent tissue transfer or rearrangement in the same areas as CPT 14060, but for defects measuring 10.1 cm2 to 30.0 cm2.
2. CPT 14301: This code is used for adjacent tissue transfer or rearrangement on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet, for defects measuring 30.1 cm2 to 60.0 cm2.
3. CPT 14302: This code is used for each additional 30.0 cm2 of adjacent tissue transfer or rearrangement on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet.
4. CPT 15200: This code is used for full-thickness skin grafts on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet, for defects measuring 20.0 cm2 or less.
5. CPT 15220: This code is used for full-thickness skin grafts on the same areas as CPT 15200, but for defects measuring 20.1 cm2 to 40.0 cm2.

10. Examples

1. A patient with a 5 cm2 defect on the lower eyelid due to skin cancer excision undergoes an adjacent tissue transfer using a rotational flap.
2. A patient with a 3 cm2 traumatic laceration on the nose undergoes an adjacent tissue transfer using an advancement flap.
3. A patient with a 7 cm2 congenital defect on the upper lip undergoes an adjacent tissue transfer using a V-Y plasty.
4. A patient with a 9 cm2 defect on the earlobe due to a previous piercing infection undergoes an adjacent tissue transfer using a double pedicle flap.
5. A patient with a 6 cm2 defect on the nasal ala due to Mohs surgery for basal cell carcinoma undergoes an adjacent tissue transfer using a Z-plasty.
6. A patient with a 4 cm2 defect on the upper eyelid due to excision of a benign lesion undergoes an adjacent tissue transfer using a W-plasty.
7. A patient with an 8 cm2 defect on the lower lip due to trauma undergoes an adjacent tissue transfer using a rotational flap.
8. A patient with a 2 cm2 defect on the nasal tip due to excision of a melanoma undergoes an adjacent tissue transfer using an advancement flap.
9. A patient with a 10 cm2 defect on the ear helix due to a previous surgery undergoes an adjacent tissue transfer using a V-Y plasty.
10. A patient with a 1 cm2 defect on the upper lip due to a dog bite undergoes an adjacent tissue transfer using a Z-plasty.