2025 CPT code 14021
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Integumentary System - Adjacent Tissue Transfer or Rearrangement Surgery Feed
Adjacent tissue transfer or rearrangement of scalp, arms, and/or legs; defect size 10.1 to 30.0 sq cm.
Modifiers such as 59 (distinct procedural service) may be used to indicate a distinct procedure when performing multiple wound repairs.Other modifiers may apply depending on specific circumstances.
Medical necessity for code 14021 is established when a significant skin defect requires reconstruction using adjacent tissue transfer to restore function and/or prevent complications like infection. The size and location of the defect must be documented to justify the selection of this code.
The surgeon's responsibilities include: patient preparation and anesthesia; precise demarcation of the lesion; excision of the lesion; elevation of the adjacent tissue flap; precise placement of the flap to cover the primary and secondary defects; meticulous hemostasis (stopping bleeding); and wound closure using appropriate techniques (sutures).
- Surgery
- Surgical Procedures on the Integumentary System > Adjacent Tissue Transfer or Rearrangement
In simple words: The doctor repairs a skin injury on the scalp, arms, or legs using healthy tissue from a nearby area. This is for injuries between 10.1 and 30 square centimeters.
This CPT code encompasses surgical procedures involving the transfer or rearrangement of adjacent tissue to repair integumentary defects (wounds) on the scalp, arms, and/or legs.The procedure is indicated for defects ranging from 10.1 to 30.0 square centimeters.The technique may involve various methods such as Z-plasty, W-plasty, V-Y plasty, rotation flap, random island flap, or advancement flap. Excision of a lesion is inherent to the procedure and not separately billable.If a skin graft is necessary to close a secondary defect resulting from the flap design, it is reported as an additional procedure. The total defect measurement (primary and secondary) determines code selection.
Example 1: A patient presents with a 15 sq cm laceration on their scalp from a motor vehicle accident. The surgeon performs a rotation flap to close the wound, using code 14021., A patient has a 20 sq cm area of chronic ulceration on their leg requiring excision and closure.The surgeon utilizes an advancement flap and code 14021 is used., A patient presents with a 25 sq cm burn wound on their arm.The surgeon excises the necrotic tissue and uses a Z-plasty technique with a skin graft to cover the resulting secondary defect, billing code 14021 and an additional code for the skin graft.
** Accurate measurement of the defect is crucial for appropriate code selection.The use of additional procedures, such as skin grafts, should be separately reported.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- RVU: Refer to the Medicare Physician Fee Schedule (MPFS) and local Medicare Administrative Contractor (MAC) for specific relative value units and reimbursement rates.These values vary based on geographic location, facility type, and other factors.
- Global Days : The global period for this surgical procedure is not explicitly defined in the CPT code description but is likely dependent on the complexity of the repair and the surgeon's judgment.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this code.
- Fee Schedule : Historical fee schedule data for this code can be accessed through various sources such as the CMS website.Fee schedules are subject to change, so always use the most current information.
- Specialties:Plastic Surgery, General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)