How To Use CPT Code 14021

CPT code 14021 describes the procedure of adjacent tissue transfer or rearrangement on the integumentary system for a defect ranging from 10.1 square centimeters to 30.0 square centimeters. 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 14021?

CPT code 14021 is used to describe the procedure of adjacent tissue transfer or rearrangement on the integumentary system. This procedure involves repairing lesions in the patient’s scalp, arms, or legs by using healthy tissues from an adjacent site. The code specifically represents a defect ranging from 10.1 square centimeters to 30.0 square centimeters.

2. Official Description

The official description of CPT code 14021 is: ‘Adjacent tissue transfer or rearrangement, scalp, arms and/or legs defect 10.1 sq cm to 30.0 sq cm.’

3. Procedure

When performing CPT code 14021, the provider begins by appropriately prepping and anesthetizing the patient. They then clearly demarcate the exact area of the lesions on the skin of the scalp, arms, and/or legs. The goal of the procedure is to perform adjacent tissue transfers (ATT) to cover the patient’s lesion by relocating a flap from adjacent normal, healthy tissue into the damaged area.

The provider proceeds with the excision of the marked area and raises a flap from the adjacent healthy tissue. This flap is then fixed into the primary or secondary integumentary defects using sutures. The provider ensures that bleeding stops and applies a clean dressing to facilitate healing.

4. Qualifying circumstances

CPT code 14021 is applicable when the patient has a defect on the scalp, arms, or legs ranging from 10.1 square centimeters to 30.0 square centimeters. The procedure involves the use of adjacent tissue transfer or rearrangement to repair the lesion. It is important to note that this code is specific to the integumentary system.

5. When to use CPT code 14021

CPT code 14021 should be used when the provider performs adjacent tissue transfer or rearrangement on the integumentary system to repair a defect ranging from 10.1 square centimeters to 30.0 square centimeters. It is important to accurately measure the size of the defect to ensure proper coding.

6. Documentation requirements

To support a claim for CPT code 14021, the provider must document the following information:

• Patient’s diagnosis and the need for adjacent tissue transfer or rearrangement
• Size of the defect in square centimeters
• Date of the procedure
• Details of the procedure, including the specific tissues used for transfer or rearrangement
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 14021, ensure that the procedure meets the criteria of adjacent tissue transfer or rearrangement on the integumentary system for a defect ranging from 10.1 square centimeters to 30.0 square centimeters. It is important to accurately document the size of the defect and the specific tissues used for transfer or rearrangement.

Additional tips for billing CPT code 14021 include:

• Do not report CPT code 14021 if the defect is 10 square centimeters or less. In such cases, use CPT code 14020.
• Be familiar with terms such as Z-plasty, W-plasty, V-Y plasty, rotational flap, advancement flap, and double pedicle flap, as they may be mentioned in the documentation.
• Remember that skin grafts required to close secondary defects are considered additional procedures and should be reported separately.

8. Historical information

CPT code 14021 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 14021

Five similar codes to CPT 14021 include:

• CPT 14020: This code is used for adjacent tissue transfer or rearrangement on the integumentary system with a defect of 10 square centimeters or less.
• CPT 14040: This code is used for adjacent tissue transfer or rearrangement on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet with a defect of 30.1 square centimeters to 60.0 square centimeters.
• CPT 14041: This code is used for adjacent tissue transfer or rearrangement on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet with a defect of 60.1 square centimeters to 100.0 square centimeters.
• CPT 14060: This code is used for adjacent tissue transfer or rearrangement on the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet with a defect of 30.1 square centimeters to 60.0 square centimeters.
• CPT 14061: This code is used for adjacent tissue transfer or rearrangement on the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet with a defect of 60.1 square centimeters to 100.0 square centimeters.

9. Examples

1. A patient has a 15 square centimeter defect on their scalp, and the provider performs adjacent tissue transfer to repair the lesion.
2. A patient has a 25 square centimeter defect on their leg, and the provider performs adjacent tissue rearrangement to cover the damaged area.
3. A patient has a 20 square centimeter defect on their arm, and the provider performs adjacent tissue transfer using a rotational flap from the adjacent healthy tissue.
4. A patient has a 12 square centimeter defect on their scalp, and the provider performs adjacent tissue rearrangement to repair the lesion.
5. A patient has a 30 square centimeter defect on their leg, and the provider performs adjacent tissue transfer to cover the damaged area.