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Adjacent Tissue Transfer: An Overview & coding Guideline

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Adjacent Tissue Transfer (Rearrangement procedures) involve the transfer or transplantation of healthy, flat sections of skin or other tissue adjacent to a wound, scar or other lesion.

ATT includes moving a part of skin from one area to an adjacent area, while leaving at least one side of the flap (moved skin) intact to retain blood supply to the graft. Incisions are made, and the skin is undermined and moved over to cover the defective area, leaving connected portion intact. The flap is then sutured into place.


Patients who should undergo adjacent tissue transfer or rearrangement are those who want to cover up skin imperfections, including:

The main advantage of an adjacent tissue transfer over skin or tissue graft is that a part of the flap remains connected to its origin.

This way, the flap has an intact and continuous blood supply. A skin graft is a piece of tissue that is separated completely from its origin. Thus, it has to wait for new blood vessels to grow before it can receive a supply of blood again.


An adjacent tissue transfer or rearrangement is performed in two stages:-

The first stage is when the local flap is taken from the donor site and sewn into the site where the lesion or skin defect is located. The two sites are connected together by a bridge of tissue called the flap pedicle, which provides continuous blood supply to the local flap for a couple of weeks.

The second stage of the process is when the flap pedicle is cut permanently. This stage is performed only when the flap already receives blood from the recipient site, and thus no longer needs the blood supply from the origin site. Once the pedicle is cut, the tissue repair is complete.

                              Coding Guidelines

Code Range :  (1400-14350)

Adjacent Tissue Transfer and Skin Replacement Procedures needed two site:-

Adjacent Tissue Transfer:  : Types of ATT like – Z Plasty, W Plasty, V-Y Plasty.

Note: Debridemen(e.g., CPT codes 11000, 11042-11047, 97597, 97598) never report with Adjacent Tissue Transfer because its first step procedure of any wound healing.


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