Overview of CPT Code 11401: Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

Overview of CPT Code 11401: Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

CPT Code 11401 refers to the surgical excision of a benign skin lesion located on the face, ears, scalp, or neck, where the excised diameter exceeds 4.0 cm. This procedure is typically performed to remove lesions that may be causing discomfort, cosmetic concerns, or have the potential for malignancy.

When CPT Code 11401 is Used?

This code is applicable in various clinical scenarios.

• Large benign skin lesions that are symptomatic or cosmetically concerning.
• Lesions that have changed in appearance or size.
• Skin lesions that require histological examination to rule out malignancy.

Symptoms Indicating This Procedure

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

• Visible growths on the skin that are larger than 4.0 cm.
• Itching or irritation associated with the lesion.
• Bleeding or oozing from the lesion.
• Changes in color or texture of the skin lesion.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention and early detection.

• Sun exposure leading to skin damage.
• Genetic predisposition to skin lesions.
• Previous skin injuries or infections.
• Certain skin conditions like seborrheic keratosis or dermatofibromas.

Diagnostic Tests Before Procedure

Prior to the excision, certain diagnostic tests may be performed.

• Physical examination of the lesion.
• Dermatoscopy to assess the lesion's characteristics.
• Biopsy may be performed if malignancy is suspected.

Procedure Description

The excision procedure involves several key 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 tissue.
• The wound is closed with sutures or adhesive strips.
• Dressing is applied to protect the area.

Preparation for the Procedure

Patients should follow specific guidelines to prepare for the excision.

• Avoid blood thinners like aspirin or ibuprofen a week prior.
• Inform the doctor about any allergies or medications.
• Arrive with clean skin, free of lotions or makeup.

Recovery and Aftercare

Post-procedure care is crucial for optimal healing.

• Keep the area clean and dry for the first few days.
• Change the dressing as instructed by the healthcare provider.
• Avoid strenuous activities for at least a week.
• Watch 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.
• Delayed healing.

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Post-Procedure Follow-Up

Follow-up care is essential to monitor healing.

• Schedule a follow-up appointment within 1-2 weeks.
• Sutures may need to be removed after 7-14 days.
• Monitor for any unusual changes in the excision site.

Alternative Treatments

There are non-surgical options for managing skin lesions.

• Cryotherapy to freeze off the lesion.
• Topical treatments for superficial lesions.
• Laser therapy for certain types of skin growths.

Home Care Tips

Patients can take steps at home to aid recovery.

• Keep the excision site clean and dry.
• Avoid picking at scabs or the wound.
• Use over-the-counter pain relief as needed.

Patient Education & Prevention

Educating patients on prevention can reduce recurrence.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect skin from UV damage.
• Avoid excessive sun exposure, especially during peak hours.

Billing and Coding Information

CPT Code: 11401

Category: Surgical Procedures

Common Modifiers:

• 50 (bilateral procedure)
• 59 (distinct procedural service)

Average Cost and Insurance Coverage

Costs can vary based on location and insurance.

• Average cost ranges from $500 to $2,000.
• Most insurance plans cover excision of benign lesions.
• Check with your insurance provider for specific coverage details.

Related CPT Codes

• 11400 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11402 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11403 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.
• 12001 - Simple Repair of Laceration, Face, Ears, Eyelids, Nose
• 12002 - Simple repair of superficial wound, face, ears, eyelids, scalp, neck

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions
• Cleveland Clinic - Skin Cancer