Summary & Overview
CPT 14001: Adjacent Tissue Transfer or Rearrangement, Trunk, 10.1–30.0 sq cm
CPT code 14001 is a nationally recognized billing code for adjacent tissue transfer or rearrangement procedures on the trunk, specifically for defects ranging from 10.1 to 30.0 square centimeters. This code is significant in reconstructive and plastic surgery, dermatology, and family medicine, as it addresses complex wound closures that require advanced surgical techniques. The procedure is commonly performed in outpatient settings or physician offices, reflecting its broad applicability across clinical environments.
Major payers covering this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a comprehensive overview of payer coverage, policy updates, and clinical benchmarks relevant to 14001. Readers will gain insight into the procedural context, typical sites of service, and the evolving reimbursement landscape, including historical and recent changes to the global period as discussed by the Relative Value Scale Update Committee (RUC).
This summary equips healthcare professionals, administrators, and policy analysts with essential information about the clinical and billing aspects of 14001, supporting informed decision-making and understanding of its role in national healthcare delivery.
CPT Code Overview
CPT code 14001 describes adjacent tissue transfer or rearrangement procedures performed on the trunk for defects measuring 10.1 sq cm to 30.0 sq cm. This service involves the movement of skin and underlying tissue from a nearby area to repair or reconstruct a defect, commonly following trauma, surgery, or other conditions affecting the trunk. The procedure is typically performed in an outpatient setting or a physician office, and historically has been associated with a global 090-day period, with recent changes discussed by the Relative Value Scale Update Committee (RUC). This code is used by clinicians specializing in reconstructive and plastic surgery, dermatology, and family medicine for cases requiring advanced wound closure techniques.
Clinical & Coding Specifications
Clinical Context
A patient presents to a physician office or outpatient setting with a significant skin defect on the trunk, measuring between 10.1 and 30.0 square centimeters. The defect may be due to surgical excision of a scar, hypertrophic scar, or laceration, or as a result of wound disruption following a previous operation. The provider, typically a plastic surgeon, dermatologist, or family medicine physician, evaluates the defect and determines that adjacent tissue transfer or rearrangement is necessary to achieve optimal closure and healing. The procedure involves mobilizing nearby skin and subcutaneous tissue to cover the defect, ensuring functional and aesthetic restoration. The workflow includes preoperative assessment, marking the area, performing the tissue transfer, and postoperative care within the global 090-day period.
Coding Specifications
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Modifier
51(Multiple Procedures): Used when more than one procedure is performed during the same operative session. Indicates that14001is one of several procedures. -
Modifier
59(Distinct Procedural Service): Used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. Applied when14001is performed separately from other procedures.
| Provider Taxonomy Code | Specialty |
|---|---|
208600000X | Plastic Surgery |
207Q00000X | Family Medicine |
207P00000X | Dermatology |
Related Diagnoses
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L90.5- Scar conditions and fibrosis of skin- Relevant for patients with skin defects due to scarring or fibrotic changes requiring tissue transfer.
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L91.0- Hypertrophic scar- Indicates a raised, thickened scar that may necessitate surgical rearrangement for functional or cosmetic reasons.
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T81.31XA- Disruption of external operation (surgical) wound, not elsewhere classified, initial encounter- Used when a surgical wound on the trunk has disrupted, requiring adjacent tissue transfer for closure.
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S01.81XA- Laceration without foreign body of other part of head, initial encounter- While primarily for head injuries, may be relevant if the procedure is performed for similar lacerations on the trunk.
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S31.119A- Laceration without foreign body of abdominal wall, initial encounter- Directly applicable for abdominal wall lacerations requiring adjacent tissue transfer or rearrangement.
Related CPT Codes
14000- Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less
14000 is used for smaller defects on the trunk (10 sq cm or less), while 14001 is for defects between 10.1 and 30.0 sq cm. These codes are alternatives based on the size of the defect. In clinical workflow, only one code is selected per defect size; they are not commonly used together.
National Reimbursement Benchmarks
For CPT code 14001, the national mean rate for Medicare is $882.65, while the average commercial benchmark (BUCA) is higher at $938.27. Among individual commercial payers, UnitedHealth Group has the highest mean rate at $1,269.24, followed by Cigna at $1,164.51, Blue Cross Blue Shield at $923.44, and Aetna at $674.21.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare shows the tightest range at $89.00, indicating relatively consistent rates. In contrast, UnitedHealth Group exhibits the widest dispersion at $777.67, suggesting greater variability in contracted rates. Cigna and BUCA also display substantial ranges, at $705.00 and $480.70 respectively, while Aetna and Blue Cross Blue Shield have moderate dispersions.
The table and chart below present the full breakdown of national benchmarks for CPT code 14001 by payer.
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