March 16, 2017
My physician excised a malignant skin lesion from the left cheek measuring 2.0 cm. The defect was repaired with a rotational advancement flap with total primary and secondary defect area of 4.75 sq cm. I submitted my claim with CPT 14040 (advancement flap), 12052-51 (repair), and 11642-51 (malignant lesion excision). My claim was denied. Did I code this correctly?
You should have reported one CPT code 14040 for the advancement flap which includes the lesion excision and repair. You should resubmit the claim with CPT 14040 and you should get paid.
*This response is based on the best information available as of 03/16/17.