Overview of CPT Code 11462: Excision, benign lesion, face, ears, scalp, neck; excised diameter over 4.0 cm

Overview of CPT Code 11462: Excision, benign lesion, face, ears, scalp, neck; excised diameter over 4.0 cm

CPT Code 11462 refers to the surgical excision of a benign lesion located on the face, ears, scalp, or neck, where the excised diameter exceeds 4.0 cm. This procedure is typically performed to remove growths that may be causing discomfort, cosmetic concerns, or have the potential for malignancy.

When CPT Code 11462 is Used?

This code is applicable in various clinical scenarios, including:

• Large benign tumors or cysts on the face, ears, scalp, or neck.
• Lesions that are symptomatic, such as causing pain or irritation.
• Cosmetic concerns where the patient desires removal of a noticeable lesion.
• Lesions that have changed in appearance or size, warranting further evaluation.

Symptoms Indicating This Procedure

Patients may report the following symptoms or clinical findings:

• Visible growth or lump on the skin.
• Pain or tenderness in the area of the lesion.
• Itching or irritation around the lesion.
• Changes in color, size, or shape of the lesion.

Causes and Risk Factors

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

• Genetic predisposition to skin growths.
• Sun exposure leading to skin changes.
• Previous skin injuries or infections.
• 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 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 eat or drink for several hours before the procedure if sedation is planned.
• Arrive at the facility with clean skin and avoid applying lotions or makeup.

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.
• Scarring or changes in skin texture.
• 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 any signs of infection or complications.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

In some cases, alternative management options may include:

• Observation for small, asymptomatic lesions.
• Cryotherapy for superficial lesions.
• Topical treatments for certain skin conditions.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the area clean and dry.
• Avoid picking at the wound.
• Use sunscreen on the healing area to prevent discoloration.

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: 11462

Category: Surgical Procedures

Common Modifiers:

• -50
• -59
• -76

Average Cost and Insurance Coverage

The cost for this procedure can vary widely:

• Average cost ranges from $500 to $2,000 depending on location and complexity.
• Most insurance plans cover excision of benign lesions if medically necessary.

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