August 21, 2014
When abdominal “dog ears” are excised after breast reconstruction surgery, is it appropriate to report the procedure with tissue rearrangement codes 14000 and 14001 when the dog ears have been excised and flaps were developed and rotated to close the wound? Or, is it more appropriate to use the excision of benign lesions codes from the 11400-11406 code series and the appropriate repair codes?
First, excision of dog ears is likely considered “cosmetic” and not covered by insurance unless you can provide medical necessity for the service. If you can establish medical necessity and/or the insurance will cover it, then you would use an excision of benign skin lesion code (e.g., 114xx) and typically an intermediate repair code (e.g., 120xx). This procedure as you’ve described it is not an appropriate use of the adjacent tissue transfer code(s).