Overview of CPT Code 11442: Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

Overview of CPT Code 11442: Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

CPT Code 11442 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 symptomatic, cosmetically concerning, or have the potential for malignancy.

When CPT Code 11442 is Used?

This code is applicable in various clinical scenarios.

• Large benign skin lesions that require surgical removal.
• Lesions that are symptomatic, causing discomfort or irritation.
• Cosmetic concerns regarding the appearance of large lesions.
• Lesions that have changed in size, shape, or color, warranting further evaluation.

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 at the site of the lesion.
• Bleeding or oozing from the lesion.
• Changes in the color or texture of the 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.
• History of skin conditions such as seborrheic keratosis or dermatofibromas.
• Weakened immune system increasing the risk of skin growths.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the need for excision.

• Physical examination of the lesion.
• Dermatoscopy to assess 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 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.

Preparation for the Procedure

Proper preparation can enhance the success of the procedure.

• Avoid blood thinners and certain medications as advised by the physician.
• Arrive with clean skin, free of lotions or makeup.
• Discuss any allergies or medical conditions with the healthcare provider.

Recovery and Aftercare

Post-procedure care is crucial for optimal healing.

• Keep the surgical site clean and dry.
• Change dressings as instructed by the healthcare provider.
• Monitor for signs of infection such as increased redness or discharge.
• Follow up for suture removal as directed.

Possible Complications

While complications are rare, they can occur.

• Infection at the surgical site.
• Scarring or changes in skin texture.
• Bleeding or hematoma formation.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up is essential to ensure proper healing.

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

Alternative Treatments

There are non-surgical options available for some patients.

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

Home Care Tips

Simple home care can aid in recovery.

• Avoid sun exposure on the healing area.
• Use gentle cleansers and avoid harsh scrubs.
• Keep the area moisturized as advised.

Patient Education & Prevention

Education is key to preventing future lesions.

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

Billing and Coding Information

CPT Code: 11442

Category: Surgical Procedures

Common Modifiers:

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

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $500 to $2,000 depending on complexity.
• Most insurance plans cover excision of benign lesions.
• Verify coverage with your insurance provider prior to the procedure.

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.
• 11403 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.
• 11404 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

References and Sources

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