Adjacent Tissue Transfer CPT Coding Guideline

Post Last Updated on 21 Feb 2026

What is Adjacent tissue transfer?

Adjacent tissue transfer refers to a surgical technique in which tissue from an area near a wound or defect is rearranged or moved to cover and repair the affected area.

What are the medical necessity of Adjacent tissue transfer?

It is performed to close the defect if surgical repair is not possible to closure the wound.

Z Plasty ( Adjacent Tissue Transfer )

CPT code range for tissue Transfer

14000-14302 : Adjacent tissue transfer

CPT Code selection Criteria for Adacent Tissue transfer

1. Codes 14000-14302 are reported based on anatomical location and defect size.The term "defect" includes the primary and secondary defects, which are measured in square centimeters.

Additional information:

Codes 14000-14302 are used for excision (including lesion) and/or repair by adjacent tissue transfer or rearrangement (eg, Zplasty, W-plasty, V-Y plasty, rotation flap, random island flap, advancement flap).

Coding guideline for Adjacent Tissue Transfer

1. In order to choose the appropriate code, add or sum the area of the primary defect (ie, excision) to the area of the secondary defect (ie, raised flap) to determine the total square centimeter area.

2. Adjacent Tissue transfer include the Excision, so if excision is peformed and to close that defect ATT is performed then code only ATT. Excision is inclusive in ATT.

3. When two or more separate wounds within the same anatomical area are repaired with one adjacent tissue rearrangement procedure, the areas of the defects are added to the area of the raised flap to determine one adjacent tissue rearrangement code.

4. However, if separate defects within the same anatomical area are repaired separately, ie, each defect is repaired with a distinct adjacent tissue rearrangement, then report an appropriate adjacent tissue rearrangement code (14000-14302) for each site. It would be appropriate to append modifier 59.

5. If debridement is necessary to perform a tissue transfer procedure, then it is included in the procedure, debridment not need to code.

6. Extensively undermining of adjacent tissue to achieve closure of a wound or defect may

   constitute complex repair, not tissue transfer and rearrangement.

   Tissue transfer and rearrangement requires that adjacent tissue be incised and carried over to close a wound or defect.

7. Skin grafting in conjunction with a repair or adjacent tissue transfer is separately

   reportable if the grafting is not included in the code descriptor of the adjacent tissue

   transfer code.

   
   

Notes: If ATT and Complex repair performed together at the same site ,what will you report ?

The question in incorrect, as ATT is performed because the other way of closure is not possible, so ATT is more extensive procedure that is performed.