CPT® Code 14021

An adjacent tissue transfer or rearrangement is a surgical procedure aimed at addressing defects located on the scalp, arms, and/or legs. These defects can arise from various causes, including traumatic wounds, lacerations, or surgical excisions of lesions or scars. The procedure begins with the evaluation of the primary defect to determine the most suitable method of tissue transfer or rearrangement. Various techniques may be employed, such as Z-plasty, W-plasty, V-Y plasty, rotation flap, advancement flap, or double pedicle flap, depending on the specific characteristics of the defect. During the procedure, adjacent skin and subcutaneous tissue are carefully incised and elevated, ensuring that one or more borders of the tissue remain attached to maintain blood supply. This action creates a secondary defect, which is then addressed by undermining the surrounding tissue to facilitate the mobilization of the skin flaps. The tissue is subsequently transferred or rearranged to effectively cover the primary defect. In some cases, the transfer may also cover the secondary defect, or alternatively, the secondary defect may be closed using a separately reportable skin graft. Accurate measurement of both the primary and secondary defects is essential to determine the appropriate coding, with CPT® Code 14021 specifically designated for defects measuring between 10.1 square centimeters and 30.0 square centimeters.