January 21, 2021

Question:
My doctor documents “significant undermining” to the free flap donor site (radial forearm) for an advancement flap. Can I also code an adjacent tissue transfer code such as 14060 for the closure?

Answer:
Actually, undermining is not considered an adjacent tissue transfer code (14xxx). CPT guidelines require a secondary defect to be created by the surgeon to move tissue and close the primary defect to support a separate adjacent tissue transfer code. “Significant undermining” is considered a complex repair code (131xx), per CPT, and this service would not be separately reported for closure of a free flap donor site – it is included in the free flap code.

*This response is based on the best information available as of 1/21/21.