Wednesday, October 19, 2016

Procedure code 14040, 14000, 14020

CODE DESCRIPTION MAXFEE

14000-2 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less $773.91

14001-2 defect 10.1 sq cm to 30.0 sq cm $1,136.94

14020-2 Adjacent tissue transfer or rearrangement, scalp, arms, legs; defect 10 sq cm or less $764.11

14021-2 defect 10.1sq cm to 30.0 sq cm $1,392.02

14040-2 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck axilae, genitalia, hands, and/or feet; defect 10 sq cm or less $1,078.05


All these codes require prior Authorization

Edit Rule


14040
Separate Reimbursement
54322
54324
54326
54328
54332
54336
54340
54344
54348
54352
54360


Use the procedure  code that best describes the procedure, the location and the size of the lesion. If there are multiple lesions, multiple codes from 11300 through 11446 or 17106 through 17111 may be used, but National Correct Coding Initiative guidelines apply for all submitted codes. For excision of benign lesions requiring more than simple closure, i.e., requiring intermediate or complex closure, report 11400-11466 in addition to appropriate intermediate (12031-12057) or complex closure (13100-13153) codes. For reconstructive closure, see 14000-14300, 15000- 15261, and 15570-15770.

procedure  codes 11400-11446 should be used when the excision is a full-thickness (through the dermis) removal of a lesion, including margins, and includes simple (non-layered) closure.
Claims for removal of benign skin lesions performed merely for cosmetic reasons may not necessarily need to be submitted to Medicare unless the patient requests that a formal Medicare denial is issued. If a claim is filed, ICD-9 CM code V50.1 (Other plastic surgery for unacceptable cosmetic appearance) should be used in conjunction with the appropriate procedure  code

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