2025 CPT code 40814
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair.
Modifiers may be applicable to this code.For instance, modifier 22 (Increased Procedural Services) may be used if the procedure was significantly more complex than typically encountered. Modifier 59 (Distinct Procedural Service) might be used if 40814 is performed in conjunction with another procedure on the same day, but is distinct and separate.Always check payer guidelines for specific modifier usage.
Medical necessity for this procedure must be established by documenting the presence of a lesion requiring surgical excision and complex repair. This may include pre-operative evaluations, diagnostic imaging if applicable, and clinical findings supporting the need for intervention.
In simple words: This procedure involves removing a growth or sore from the inside lining of your cheek or lip, and then repairing the area with a more involved stitching technique due to the complexity of the wound.
This code describes the surgical removal of a lesion located in the mucosa and submucosa of the vestibule of the mouth, involving a complex repair of the surgical wound.The vestibule of the mouth refers to the area between the cheeks and lips externally and the teeth and gums internally.Complex repair often involves techniques such as advancement of tissue flaps, rearrangement of tissues, or complex suturing techniques to close the wound.
Example 1: A patient presents with a lesion on the inner cheek, requiring excision and a multi-layered closure due to the depth of the excision., A patient has a lesion involving the lip mucosa and submucosa, necessitating excision and a complex flap repair for optimal cosmetic outcome. , Following a traumatic injury to the mouth, a patient needs excision of damaged tissue in the vestibule and complex repair due to irregular wound margins.
Documentation should include the location and size of the lesion, the complexity of the repair, operative details, and a copy of the pathology report.
- Specialties:Oral and Maxillofacial Surgery, Plastic Surgery, Otolaryngology
- Place of Service:Office, Ambulatory Surgical Center, Hospital Outpatient