CPT Code 14000: Adjacent Tissue Transfer or Rearrangement, Trunk, <10.1 cm²

Learn about CPT code 14000 for adjacent tissue transfer of trunk defects ≤10.0 sq cm, including documentation, billing, modifiers, and surgical guidelines.

Use Code

What is adjacent tissue transfer?

CPT code 14000 is used to describe adjacent tissue transfer or rearrangement of the skin and subcutaneous tissue of the trunk for defects measuring 10.0 sq cm or less. This procedure is more complex than a standard wound closure and involves techniques such as advancement flaps, rotation flaps, or transposition flaps to repair surgical or traumatic defects.

These procedures are common in plastic surgery, particularly after excision of skin cancer lesions or other skin disorders. The technique mobilizes adjacent skin (rather than grafts from distant sites) to reconstruct the wound with better aesthetic and functional outcomes, especially in areas of tension or anatomical complexity.

This tissue transfer approach is considered distinct from intermediate or complex closure, as it involves the rearrangement of tissue. Hence it must be reported with its unique CPT code to ensure accurate billing and proper reimbursement.

Use of adjacent tissue transfer in plastic surgery

This is where simple closure is not optimal due to the size, shape, or location of a defect. The tissue transfer or rearrangement provides superior outcomes, especially in cosmetically sensitive areas. In some cases, it may be used in combination with other surgical interventions during the postoperative period, but clear documentation is needed to avoid denials when multiple procedures are billed.

CPT code 14000 documentation requirements

To support billing for CPT 14000, healthcare providers must include:

Size of the defect in sq cm prior to closure (must be 10.0 sq cm or less)
Precise anatomical location of the defect (only applicable to the trunk)
Flap technique used, such as advancement, rotation, or Z-plasty
Tissue rearrangement plan, preferably with diagrams or detailed written descriptions
Medical necessity, explaining why primary closure or grafting was not feasible
Notes on any related procedure performed during the same surgical session

These details are essential for accurate coding and to avoid claim denials from insurance payers.

CPT code 14000 billing guidelines

When coding for adjacent tissue transfer or rearrangement, the following rules apply:

Do not report CPT 14000 in conjunction with intermediate or complex repair codes (e.g., 12001–13160) at the same site. The closure is included in the tissue transfer.
Do report excision codes (e.g., 11400–11646) separately if performed during the same surgical session. The excision is not bundled.
Use 14001 for each additional 10 sq cm or part thereof on the same anatomic group.
CPT 14000 represents both flap creation and wound closure. Do not bill them separately.
Append appropriate modifiers (e.g., Modifier 59) if a distinct procedural service or multiple procedures are performed at separate anatomic sites.
If the procedure is a bilateral procedure, use Modifier 50 where appropriate and ensure the same physician performed the work.
If the complexity of the flap requires increased procedural services, consider Modifier 22, supported by thorough documentation.
Assign place of service and modifiers based on location and operative report specifics to ensure accurate billing. The American Medical Association emphasizes the importance of detailed clinical notes to support such billing decisions.

Other relevant CPT codes

14001: Additional 10 cm² on the same anatomical group.
14301–14302: Tissue rearrangement, >30 cm².

Frequently asked questions

The 14000 CPT code specifically applies to adjacent tissue transfer procedures involving defects measuring 10.0 square centimeters or less on the trunk. If the defect exceeds this size, additional units such as 14001 should be reported for every additional 10 cm² or part thereof. Accurate measurement in square centimeters is essential to ensure proper code selection and avoid billing discrepancies.

CPT code 14000 is used when the surgeon performs a flap procedure—such as advancement, rotation, or transposition flaps—to close a wound. These techniques are necessary under circumstances where linear closure is not sufficient due to factors like tissue tension, location, size, or the patient’s condition. Unlike a simple excision with closure, this service involves tissue rearrangement, which is more technically demanding and must be clearly documented.

Yes, if complications from lesion removal require adjacent tissue rearrangement for wound closure, CPT code 14000 can be reported. However, the surgeon must document how the patient’s wound required flap coverage due to complexity or delayed healing.