Overview of CPT Code 11104:biopsy-of-skin-excised-lesion-each-additional

Overview of CPT Code 11104:biopsy-of-skin-excised-lesion-each-additional

CPT Code 11104 refers to the biopsy of skin, specifically for excised lesions that are additional to the first biopsy performed. This procedure is commonly used in dermatology to obtain tissue samples for diagnostic purposes.

When CPT Code 11104 is Used?

CPT Code 11104 is indicated in various clinical scenarios.

• When multiple skin lesions require biopsy during a single visit.
• For lesions that appear suspicious for malignancy after initial examination.
• In cases where a previous biopsy has shown atypical cells and further sampling is needed.

Symptoms Indicating This Procedure

Patients may report various symptoms that lead to the need for a biopsy.

• New or changing moles or skin lesions.
• Lesions that are itchy, painful, or bleeding.
• Skin growths that have an irregular shape or color.

Causes and Risk Factors

Several factors can contribute to the development of skin lesions.

• Sun exposure leading to skin damage.
• Family history of skin cancer.
• Previous skin cancer diagnoses.

Diagnostic Tests Before Procedure

Certain tests may be conducted prior to the biopsy.

• Physical examination of the skin lesions.
• Dermatoscopy to evaluate the characteristics of the lesions.
• Previous biopsy results if applicable.

Procedure Description

The biopsy procedure involves several key steps.

• The area around the lesion is cleaned and sterilized.
• Local anesthesia is administered to minimize discomfort.
• A scalpel is used to excise the lesion along with a margin of surrounding tissue.
• The sample is sent to a laboratory for histopathological examination.

Preparation for the Procedure

Patients should follow specific guidelines before the biopsy.

• Avoid blood thinners for a few days prior to the procedure.
• Inform the doctor about any allergies, especially to anesthetics.
• Arrive with clean skin, free of lotions or creams.

Recovery and Aftercare

Post-procedure care is essential for healing.

• Keep the biopsy site clean and dry.
• Apply any prescribed ointments as directed.
• Monitor for signs of infection such as increased redness or discharge.

Possible Complications

While generally safe, there are potential risks.

• Infection at the biopsy site.
• Excessive bleeding.
• Scarring or changes in skin pigmentation.

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Post-Procedure Follow-Up

Follow-up appointments are crucial for monitoring.

• Typically scheduled within 1-2 weeks to discuss biopsy results.
• Additional follow-ups may be needed based on findings.
• Regular skin checks may be recommended for high-risk patients.

Alternative Treatments

There are non-surgical options for managing skin lesions.

• Topical treatments for benign lesions.
• Cryotherapy for certain skin growths.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can take steps to aid recovery at home.

• Avoid sun exposure on the biopsy site until healed.
• Use gentle cleansers and avoid harsh scrubs.
• Keep the area moisturized to promote healing.

Patient Education & Prevention

Education is key to preventing skin issues.

• Regular skin checks for early detection of changes.
• Use sunscreen to protect against UV damage.
• Avoid tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 11104

Category: Surgical Procedures

Common Modifiers:

• 51 - Multiple procedures
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $200 to $500 depending on the complexity.
• Most insurance plans cover medically necessary biopsies.
• Patients should verify coverage with their insurance provider.

Related CPT Codes

• 11100 - Biopsy of skin, single lesion
• 11101 - Biopsy of skin, excisional, single lesion
• 17000 - Destruction of benign skin lesions
• 17003 - Destruction of benign skin lesions, 15 or more lesions
• 11400 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

References and Sources

• American Academy of Dermatology
• National Institutes of Health
• Mayo Clinic - Skin Biopsy