Forum - Questions & Answers

Nov 15th, 2016 - Stinkyharris

Adjacent tissue Rearrangement - Size limitation

A physician wants to perform lesion removals and perform adjacent tissue rearrangement.

I am aware documentation must support 2 separate incisions/defects.

My question is, can ATR be billed for lesions under 1cm? Is there a "minimal" requirement?

I have research this and can not find anything. Some of these are lesions of .5cm and less.

Any help would be greatly appreciated.

Mar 1st, 2018 - ChrisW   256  1 

re: Adjacent tissue Rearrangement - Size limitation

There are several options for excisions with one being the excised diameter of 0.5 cm or less. For example, for trunk, arms or legs excising a benign lesion that included margins (not skin tags) with the excised diameter being 0.5 cm (or less), you would consider CPT code 11400.

For excision diameter 0.6-1.0 cm, 11402 for excision diameter of 1.1-2.0 cm, 11403 for excision diameter of 2.1-3.0 cm, 11404 for excision diameter of 3.1-4.0, and 11406 for excision diameter of over 4.0 cm.

The Adjacent tissue transfer or rearrangement is also coded by body region, so be careful to make sure you are using the correct code. For example Use 14020 for a defect of 10 sq cm (or less) and 14021 if the defect measures 10.1 square cm to 30 square cm.

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