Coding for Goldilocks

Question:

How do I code for a “Goldilocks” Reconstruction?

Answer:

KZA would like to thank you for this great question!

In the “Goldilocks” procedure, what remains of skin following a mastectomy is used to create a breast mound.

The ASPS advises using an adjacent tissue transfer code (ATT 14XXX), with the dimension based only on the inferior tissue that is separately incised and transferred to create the breast mound. They also describe this procedure as “similar to” an autoderm flap.

In a CPT Assistant from April 2021, there is an instruction to report the adjacent tissue transfer codes for reporting a de-epithelialized autoderm flap based only on the transposed area.

To assign the appropriate code for the Goldilocks procedure, the dimension based only on the inferior tissue that is separately incised and transferred should be documented clearly. The remaining skin closure is considered included.

*This response is based on the best information available as of 6/05/25.