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The CPT® Code 41114 refers to the excision of a lesion located on the tongue, specifically involving the use of a local tongue flap for closure. This procedure is performed under local anesthesia, which is administered around and beneath the lesion to ensure patient comfort during the operation. The surgeon makes an incision that penetrates through the epithelium, reaching into the underlying fibrous tissue and muscle. This incision is carefully crafted to encircle the lesion, allowing for its complete excision along with a margin of healthy tissue to ensure that no residual disease remains. Following the excision, the removed lesion is sent to a laboratory for pathology examination, which is a separate reportable service. This procedure is distinct from other related codes, such as CPT® 41110, which involves the excision of a small superficial lesion without the need for closure, and CPT® 41112 and CPT® 41113, which pertain to the excision of larger lesions in specific areas of the tongue with suture repair. In contrast, CPT® 41114 specifically utilizes a local tongue flap technique, where adjacent myomucosal tissue is incised, elevated, and rotated to cover the defect left by the excised lesion. The flap is then sutured in place, and the donor site is also closed with sutures, ensuring a functional and aesthetic repair of the tongue.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure coded as CPT® 41114 is indicated for the excision of lesions on the tongue that require a more extensive surgical approach due to their size or depth. This may include lesions that are not superficial and necessitate the removal of surrounding healthy tissue to ensure complete excision. The use of a local tongue flap for closure is particularly indicated when the defect created by the excision is significant enough that simple suture repair would not provide adequate coverage or functional restoration of the tongue.
The procedure begins with the administration of a local anesthetic around and beneath the lesion to ensure the patient remains comfortable throughout the surgery. Following anesthesia, the surgeon makes a precise incision through the epithelium, extending into the underlying fibrous tissue and muscle. This incision is carefully crafted to encircle the lesion, allowing for its complete removal. The excision is performed with a margin of healthy tissue to ensure that all potentially affected areas are included, minimizing the risk of recurrence. Once the lesion is excised, it is sent to a laboratory for pathology examination, which is a separate reportable service. After the lesion has been removed, the next step involves the creation of a local tongue flap. Adjacent myomucosal tissue is incised and elevated, allowing it to be rotated over the defect left by the excision. This flap is then sutured securely over the surgical site to promote healing and restore the tongue's structure. Finally, the donor site from which the flap was taken is also closed with sutures, ensuring that the surgical area is properly managed and that the patient can expect a functional recovery.
After the procedure, patients can expect to receive specific post-operative care instructions to promote healing and minimize complications. This may include recommendations for pain management, dietary modifications to accommodate the healing tongue, and instructions on oral hygiene to prevent infection at the surgical site. Patients are typically advised to avoid certain foods that may irritate the surgical area and to follow up with their healthcare provider for monitoring the healing process. The recovery period may vary depending on the extent of the excision and the individual patient's healing response, but close attention to the surgical site is essential to ensure proper recovery and function of the tongue.
| Short Descr | EXCISION OF TONGUE LESION | Medium Descr | EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP | Long Descr | Excision of lesion of tongue with closure; with local tongue flap | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 2 | CCS Clinical Classification | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | SG | Ambulatory surgical center (asc) facility service |
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| 2011-01-01 | Changed | Guideline information changed. |
| Pre-1990 | Added | Code added. |
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