AHA Coding Clinic® for HCPCS - 2014 Issue 2; Ask the Editor

Excision of breast lesion with adjacent tissue transfer

Patients at our facility have breast lesion excisions to a depth that includes skin and subcutaneous tissue and some that require resection to the muscle. Some of the lesions are identified by a localization device. However, as a result, there are large defects from the wide excisions. Sometimes closure of the defect requires adjacent tissue transfer or rearrangement. Based on CPT guidelines, excisions of benign lesions (11400–11446) and malignant lesions (11600–11646) cannot be reported separately with adjacent tissue transfer or rearrangement codes (14000–14302). Although the excision of a lesion of the breast is coded to a different CPT code range, does the same principle for the excision of skin lesions apply? Would excision of the breast lesion(s) be included with the adjacent tissue transfer codes? Also, would the placement of the breast localization device be reported separately? ...

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