Overview of CPT Code 11423: Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

Overview of CPT Code 11423: Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

CPT Code 11423 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 11423 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 patient desires removal for aesthetic reasons.
• Lesions that have changed in appearance or size, warranting further evaluation.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of this procedure, including:

• 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 color or texture of the skin lesion.

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 characteristics of the lesion.
• Biopsy if there is suspicion of malignancy.

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, ensuring complete removal.
• The lesion is excised, and the surrounding tissue is examined.
• The incision is closed with sutures or adhesive strips.

Preparation for the Procedure

Patients should follow these preparation steps before the procedure:

• Avoid blood-thinning medications for a week prior, if advised.
• Inform the physician of any allergies or medical conditions.
• Arrive with clean skin, free of lotions or makeup.
• Arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Resting for the remainder of the day after the procedure.
• Keeping the surgical site clean and dry.
• Changing dressings as instructed by the healthcare provider.
• Taking prescribed pain medications as needed.

Possible Complications

While generally safe, potential complications may include:

• Infection at the surgical site.
• Excessive bleeding during or after the procedure.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up care is essential for monitoring recovery:

• Schedule a follow-up appointment within 1-2 weeks to assess healing.
• Monitor for signs of infection or complications.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

In some cases, alternative treatments may be considered:

• Topical treatments for smaller lesions.
• Cryotherapy for superficial lesions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can follow these home care tips for optimal recovery:

• Avoid strenuous activities for a few days post-procedure.
• Keep the area moisturized as directed.
• Avoid sun exposure on the healing site.
• Report any unusual symptoms to the healthcare provider.

Patient Education & Prevention

To prevent recurrence and promote skin health:

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

Billing and Coding Information

CPT Code: 11423

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• RT - Right side
• LT - Left side

Average Cost and Insurance Coverage

The cost for this procedure can vary widely:

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

Related CPT Codes

• 11420 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm
• 11421 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm
• 11422 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm
• 11424 - 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