Closure After a Partial Mastectomy, Code 19301
Question:
Adjacent tissue transfers, 14000 series to include 14301 and 14302 with 19301 Mastectomy. I see where you clarify 14000 (ADJ flaps) to eliminate dead space is inherent to a mastectomy procedure. My question is does this include codes 14301 and 14302? I'm asking because there was a Q & A 2017 CPT Assistance Article stating "14000 and 14001 are not reported separately because simple, intermediate and complex layered closure is included in the work represented by code 19301". As such, our guidance is that it is ok to bill separately for codes 14301 and 14302 with 19301 when the defect is larger than 30 sq cm.
Answer:
This is a common misunderstanding. It does not matter how large a defect remains after a partial mastectomy, closure by a local advancement flap or an oncoplastic repair do not support an adjacent tissue transfer. Codes 14301, 14302 should not be reported for these closures regardless of the size of the defect.
See below for guidance from the American College of Surgeons national coding courses.
There are no additional codes for closure after a partial mastectomy, code 19301
Elimination of dead space is inherent to a mastectomy procedure.
Complex closure (13100-13102, 13131-13133) is included in any mastectomy procedure.
Local advancement flaps and oncoplastic repair are included in a mastectomy procedure.
Adjacent tissue transfer (ATT) (14000-14302) is not commonly performed with a mastectomy (e.g., 19120, 19125). A closure defined as a local advancement flap or an oncoplastic repair is most commonly a skin advancement flap that does not meet the definition of a true ATT.
If a complex repair is substantially greater than typically required, it may be appropriate to append modifier 22, Increased Procedural Services, to the mastectomy code. Documentation must support the substantial additional work and the reason for the additional work (i.e., increased intensity, time technical difficulty of the procedure, severity of patient’s condition, physical and mental effort required.
*This response is based on the best information available as of 12/04/25.
