Overview of CPT Code 11312: Excision, benign skin lesion; excised diameter over 4.0 cm

Overview of CPT Code 11312: Excision, benign skin lesion; excised diameter over 4.0 cm

CPT Code 11312 refers to the surgical excision of a benign skin lesion with an excised diameter greater than 4.0 cm. This procedure is typically performed to remove lesions that may be symptomatic, cosmetically concerning, or have the potential for malignancy.

When CPT Code 11312 is Used?

This code is applicable in various clinical scenarios.

• Large benign skin lesions causing discomfort or irritation.
• Lesions that are cosmetically unappealing to the patient.
• Suspicious lesions that require removal for histopathological examination.

Symptoms Indicating This Procedure

Patients may report various symptoms that lead to the consideration of this procedure.

• Persistent itching or irritation at the site of the lesion.
• Bleeding or oozing from the lesion.
• Changes in the appearance of the lesion, such as color or size.

Causes and Risk Factors

Several factors can contribute to the development of benign skin lesions.

• Genetic predisposition to skin growths.
• Sun exposure leading to skin changes.
• Previous skin injuries or infections.

Diagnostic Tests Before Procedure

Certain tests may be conducted to assess the lesion prior to excision.

• Physical examination of the lesion.
• Dermatoscopy to evaluate the characteristics of the lesion.
• Biopsy if malignancy is suspected.

Procedure Description

The excision procedure follows a systematic approach.

• 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 tissue.
• The wound is closed with sutures or adhesive strips.
• Dressing is applied to protect the site.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Avoid blood thinners for a week prior to the procedure.
• Inform the physician of any allergies or medications.
• Arrive with clean skin and avoid applying lotions or creams.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Keep the area clean and dry for the first few days.
• Change the dressing as instructed by the healthcare provider.
• Monitor for signs of infection such as increased redness or discharge.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

• Infection at the excision site.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up appointments are important for monitoring recovery.

• Schedule a follow-up visit within 1-2 weeks to assess healing.
• Discuss pathology results if the lesion was sent for analysis.
• Report any unusual symptoms immediately.

Alternative Treatments

There are non-surgical options for managing benign skin lesions.

• Topical treatments for superficial lesions.
• Cryotherapy to freeze off certain types of lesions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can take steps at home to aid recovery.

• Avoid sun exposure on the healing site.
• Use over-the-counter pain relief as needed.
• Stay hydrated and maintain a balanced diet to support healing.

Patient Education & Prevention

Educating patients on skin health is vital.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect skin from UV damage.
• Seek medical advice for any concerning skin changes.

Billing and Coding Information

CPT Code: 11312

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 $300 to $1,500 depending on the complexity.
• Most insurance plans cover the procedure if deemed medically necessary.

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
• 11400 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11401 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions