Overview of CPT Code 11404: Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

Overview of CPT Code 11404: Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

CPT Code 11404 refers to the surgical excision of a benign skin lesion located on the face, ears, or scalp, 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 11404 is Used?

This code is applicable in various clinical scenarios, including:

• Large benign skin lesions that require surgical removal.
• Lesions that are symptomatic, such as causing pain or irritation.
• Cosmetic concerns where the lesion's size or location affects appearance.
• Lesions that have changed in size, shape, or color, warranting further evaluation.

Symptoms Indicating This Procedure

Patients may report the following symptoms that lead to the consideration of this procedure:

• Visible growths on the skin that are larger than 4.0 cm.
• 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 texture.

Causes and Risk Factors

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

• Genetic predisposition to skin growths.
• Sun exposure leading to skin changes.
• Previous skin injuries or trauma.
• Certain skin conditions, such as seborrheic keratosis or lipomas.

Diagnostic Tests Before Procedure

Before proceeding with the excision, the following diagnostic tests may be conducted:

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

Procedure Description

The excision procedure typically follows these steps:

• Patient is positioned comfortably and the area is cleaned.
• Local anesthesia is administered to numb the area.
• A surgical incision is made around the lesion.
• The lesion is carefully excised 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 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 prior to the procedure.
• Arrive at the appointment with a clean face and scalp.
• Discuss any allergies or medical conditions with the healthcare provider.

Recovery and Aftercare

Post-procedure recovery typically involves the following:

• Wound care instructions, including keeping the area clean and dry.
• Pain management with over-the-counter medications as needed.
• Monitoring for signs of infection, such as increased redness or discharge.
• Follow-up appointment to remove sutures and assess healing.

Possible Complications

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

• Infection at the excision site.
• Scarring or changes in skin texture.
• Bleeding during or after the procedure.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up care is essential for optimal recovery:

• Schedule a follow-up visit within 1-2 weeks post-procedure.
• Monitor the healing process and address any concerns.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

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

• Cryotherapy to freeze and remove the lesion.
• Laser therapy for targeted removal.
• Topical treatments for smaller lesions.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the excision site clean and dry.
• Avoid picking at scabs or the wound.
• Use sunscreen on the area to prevent discoloration.
• Follow all post-operative instructions provided by the healthcare provider.

Patient Education & Prevention

To prevent future lesions, consider the following:

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect skin from UV damage.
• Maintain a healthy lifestyle to support skin health.
• Consult a dermatologist for persistent or concerning skin changes.

Billing and Coding Information

CPT Code: 11404

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:

• Average cost ranges from $500 to $2,000 depending on the complexity.
• Most insurance plans cover excision of benign lesions.
• Patients should verify coverage details with their insurance provider.

Related CPT Codes

• 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.
• 11402 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11406 - 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