How To Use CPT Code 14020

CPT code 14020 describes the procedure of adjacent tissue transfer or rearrangement for the repair of defects in the patient’s scalp, arms, and/or legs. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 14020?

CPT 14020 is a code used to describe the procedure of adjacent tissue transfer or rearrangement for the repair of defects in the patient’s scalp, arms, and/or legs. This procedure involves the use of healthy tissues from an adjacent site to repair the primary or secondary integumentary defects, which are 10 square centimeters or less in size.

2. Official Description

The official description of CPT code 14020 is: ‘Adjacent tissue transfer or rearrangement, scalp, arms and/or legs defect 10 sq cm or less.’

3. Procedure

During the procedure of adjacent tissue transfer or rearrangement (ATT), the provider prepares the patient by ensuring appropriate prepping and anesthesia. The provider then makes an incision around the healthy tissue surrounding the defect to prepare it for transfer. The healthy tissue is then transplanted to the primary or secondary integumentary defects of the scalp, arms, and/or legs. The provider attaches the tissue and closes the incisions using sutures.

4. Qualifying circumstances

CPT 14020 is used for patients who have defects in their scalp, arms, and/or legs that require repair or reconstruction. These defects should be 10 square centimeters or less in size. The procedure is performed by a qualified healthcare professional who is trained in adjacent tissue transfer or rearrangement techniques.

5. When to use CPT code 14020

CPT code 14020 should be used when a patient has a defect in their scalp, arms, and/or legs that is 10 square centimeters or less in size and requires repair or reconstruction using adjacent tissue transfer or rearrangement techniques. It is important to accurately measure the size of the defect to determine if it falls within the criteria for this code.

6. Documentation requirements

To support a claim for CPT 14020, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for adjacent tissue transfer or rearrangement
• Size of the defect in square centimeters
• Details of the procedure performed, including the incision, tissue transfer, and closure
• Any additional procedures or techniques used, such as Z-plasty, W-plasty, V-Y plasty, rotational flap, advancement flap, or double pedicle flap
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 14020, ensure that the procedure meets the criteria for adjacent tissue transfer or rearrangement for defects of 10 square centimeters or less in the scalp, arms, and/or legs. It is important to accurately document the size of the defect and the details of the procedure performed. Additionally, be aware that skin grafts necessary to close secondary defects are considered additional procedures and should be billed separately. It is also important to note that lesion removal is included in the tissue transfer procedure and should not be billed separately.

8. Historical information

CPT 14020 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 14020

Five similar codes to CPT 14020 include:

• CPT 14021: This code is used for adjacent tissue transfer or rearrangement procedures on the integumentary system for defects of 10.1 to 30 square centimeters in size.
• CPT 14040: This code is used for tissue transfer or rearrangement procedures on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet for defects of 30 square centimeters or less in size.
• CPT 14041: This code is used for tissue transfer or rearrangement procedures on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet for defects of 30.1 to 60 square centimeters in size.
• CPT 14060: This code is used for tissue transfer or rearrangement procedures on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet for defects of 60.1 to 100 square centimeters in size.
• CPT 14061: This code is used for tissue transfer or rearrangement procedures on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet for defects of over 100 square centimeters in size.

9. Examples

1. A patient with a 5 square centimeter defect on their scalp undergoes adjacent tissue transfer to repair the defect.
2. A patient with a 7 square centimeter defect on their leg undergoes adjacent tissue transfer to reconstruct the area.
3. A patient with a 9 square centimeter defect on their arm undergoes adjacent tissue transfer to repair the defect.
4. A patient with a 10 square centimeter defect on their scalp and a 5 square centimeter defect on their leg undergoes adjacent tissue transfer to repair both defects.
5. A patient with a 3 square centimeter defect on their leg undergoes adjacent tissue transfer to reconstruct the area.
6. A patient with a 6 square centimeter defect on their scalp undergoes adjacent tissue transfer to repair the defect.
7. A patient with a 8 square centimeter defect on their arm undergoes adjacent tissue transfer to reconstruct the area.
8. A patient with a 4 square centimeter defect on their leg undergoes adjacent tissue transfer to repair the defect.
9. A patient with a 2 square centimeter defect on their scalp and a 7 square centimeter defect on their arm undergoes adjacent tissue transfer to repair both defects.
10. A patient with a 9 square centimeter defect on their leg undergoes adjacent tissue transfer to reconstruct the area.