Overview of CPT Code 11470: Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

Overview of CPT Code 11470: Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

CPT Code 11470 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 11470 is Used?

This code is applicable in various clinical scenarios.

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

Symptoms Indicating This Procedure

Patients may report several symptoms that warrant 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.

• 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

Several tests may be conducted prior to the excision.

• Physical examination of the lesion.
• Dermatoscopy to assess the lesion's characteristics.
• 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 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

Proper preparation is essential for a smooth procedure.

• Avoid blood thinners like aspirin or ibuprofen a week prior.
• Inform the doctor about any allergies or medications.
• Arrive with clean skin and avoid applying lotions or creams.

Recovery and Aftercare

Post-procedure care is crucial for 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 pus.

Possible Complications

While generally safe, there are potential risks.

• 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 is important to monitor healing.

• Schedule a follow-up appointment within 1-2 weeks.
• Remove sutures if applicable during the follow-up.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

There are non-surgical options available.

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

Home Care Tips

Simple tips can aid in 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

Education is key to preventing future lesions.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect against UV damage.
• Avoid tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 11470

Category: Surgical Procedures

Common Modifiers:

• -50
• -59
• -76

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $500 to $2,000.
• Insurance may cover the procedure if deemed medically necessary.
• 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.
• 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