Overview of CPT Code 11307: Removal of skin lesion, excised, excised diameter over 4.0 cm

Overview of CPT Code 11307: Removal of skin lesion, excised, excised diameter over 4.0 cm

CPT Code 11307 refers to the surgical removal of a skin lesion that has an excised diameter greater than 4.0 cm. This procedure is typically performed to eliminate lesions that may be cancerous, precancerous, or symptomatic, ensuring both cosmetic and health-related outcomes.

When CPT Code 11307 is Used?

This code is applicable in various clinical scenarios, including but not limited to:

• Large benign skin lesions that require excision for cosmetic reasons.
• Suspicious lesions that need to be removed for biopsy and further analysis.
• Malignant skin tumors that necessitate complete excision to prevent spread.

Symptoms Indicating This Procedure

Patients may present with several symptoms that warrant the excision of a skin lesion, including:

• Visible growths on the skin that change in size or color.
• Lesions that bleed, itch, or become painful.
• Skin lesions that have irregular borders or asymmetrical shapes.

Causes and Risk Factors

Various factors can contribute to the development of skin lesions, including:

• Sun exposure leading to skin damage and lesions.
• Genetic predisposition to skin conditions.
• Previous skin cancer history or family history of skin cancer.

Diagnostic Tests Before Procedure

Prior to the excision, several diagnostic tests may be conducted to ensure proper treatment:

• Skin biopsy to determine the nature of the lesion.
• Dermatoscopy to examine the lesion in detail.
• Imaging studies if deeper tissue involvement is suspected.

Procedure Description

The procedure for excising a skin lesion typically follows these steps:

• Patient is positioned comfortably and the area is cleaned.
• Local anesthesia is administered to numb the area.
• A scalpel is used to excise the lesion along with a margin of healthy skin.
• The wound is closed with sutures or adhesive strips, depending on the size.

Preparation for the Procedure

Patients should follow these steps to prepare for the excision:

• Avoid blood thinners and certain medications as advised by the physician.
• Do not apply any creams or lotions to the lesion area on the day of the procedure.
• Arrive at the appointment with a clean and dry skin surface.

Recovery and Aftercare

Post-procedure recovery typically involves the following:

• Keep the surgical site clean and dry for the first few days.
• Change dressings as instructed and watch for signs of infection.
• Pain relief medications may be prescribed as needed.

Possible Complications

While generally safe, this procedure may carry some risks, including:

• Infection at the surgical site.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion if not completely excised.

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Post-Procedure Follow-Up

Follow-up appointments are essential for monitoring recovery:

• Typically scheduled within 1-2 weeks post-procedure to check healing.
• Additional follow-ups may be necessary based on biopsy results.
• Patients should report any unusual symptoms immediately.

Alternative Treatments

In some cases, non-surgical options may be considered, such as:

• Cryotherapy for freezing off benign lesions.
• Topical treatments for superficial skin cancers.
• Laser therapy for certain types of skin lesions.

Home Care Tips

Patients can follow these tips for effective home care:

• Avoid sun exposure on the healing area; use sunscreen if necessary.
• Do not pick at scabs or the surgical site to prevent scarring.
• Keep the area moisturized as advised by the healthcare provider.

Patient Education & Prevention

To prevent skin lesions and their recurrence, patients should consider:

• Regular skin checks for new or changing lesions.
• Use of sunscreen and protective clothing when outdoors.
• Avoiding tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 11307

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

The cost for this procedure can vary widely based on several factors:

• Average costs range from $500 to $2,000 depending on complexity.
• Most insurance plans cover this procedure if deemed medically necessary.
• Patients should verify coverage details with their insurance provider.

Related CPT Codes

• 11300 - Removal of skin lesion, excised, benign, face, ears, scalp, neck
• 11301 - Shaving of Skin Lesion, Face, Ears, Scalp
• 11302 - Shaving of skin lesion, excised diameter over 4.0 cm
• 11303 - Shaving of skin lesion, excised diameter over 4.0 cm

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions