Overview of CPT Code 11604: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
CPT Code 11604 refers to the surgical excision of a malignant 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 cancerous growths and prevent the spread of malignancy.
When CPT Code 11604 is Used?
This code is applicable in various clinical scenarios.
- Presence of a malignant skin lesion larger than 4.0 cm.
- Lesions that have been confirmed as cancerous through biopsy.
- Lesions located on cosmetically sensitive areas such as the face or neck.
Symptoms Indicating This Procedure
Patients may report several symptoms that necessitate this procedure.
- Visible growth on the skin that changes in size, shape, or color.
- Bleeding or oozing from the lesion.
- Itching or discomfort in the affected area.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention.
- Excessive sun exposure leading to skin damage.
- Family history of skin cancer.
- Weakened immune system due to conditions like HIV or medications.
Diagnostic Tests Before Procedure
Several tests may be conducted to confirm the diagnosis.
- Skin biopsy to determine the nature of the lesion.
- Imaging studies like ultrasound if deeper tissue involvement is suspected.
Procedure Description
The excision procedure involves several key steps.
- Patient is positioned comfortably and the area is cleaned.
- Local anesthesia is administered to numb the area.
- The surgeon excises the lesion along with a margin of healthy tissue.
- The wound is closed with sutures or adhesive strips.
Preparation for the Procedure
Proper preparation is essential for a successful procedure.
- Avoid blood thinners like aspirin or ibuprofen a week prior.
- Discuss any allergies with your healthcare provider.
- Arrive with clean skin and avoid applying lotions or makeup.
Recovery and Aftercare
Post-procedure care is crucial for healing.
- Keep the surgical site clean and dry.
- Change dressings as instructed by your healthcare provider.
- Avoid strenuous activities for at least two weeks.
Possible Complications
While complications are rare, they can occur.
- Infection at the surgical site.
- Scarring or changes in skin pigmentation.
- Recurrence of the malignant lesion.
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Post-Procedure Follow-Up
Follow-up appointments are important for monitoring.
- Schedule a follow-up visit within 1-2 weeks post-surgery.
- Monitor for any signs of infection or complications.
- Discuss pathology results and further treatment if necessary.
Alternative Treatments
There are non-surgical options available.
- Topical chemotherapy for superficial skin cancers.
- Cryotherapy to freeze off precancerous lesions.
Home Care Tips
Simple tips can aid in recovery.
- Keep the area moisturized with recommended ointments.
- Avoid sun exposure on the healing site.
- Follow all post-operative instructions from your healthcare provider.
Patient Education & Prevention
Education is key to preventing skin cancer.
- Regular skin checks for new or changing lesions.
- Use sunscreen with a high SPF to protect against UV rays.
- Avoid tanning beds and excessive sun exposure.
Billing and Coding Information
CPT Code: 11604
Category: Surgical Procedures
Common Modifiers:
- 50 (bilateral procedure)
- RT (right side)
- LT (left side)
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $1,500 to $3,000.
- Most insurance plans cover excision of malignant lesions.
Related CPT Codes
- 11603 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
- 11602 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
- 11606 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
References and Sources
Frequently Asked Questions (FAQs)
What is the purpose of this procedure?
The procedure aims to remove malignant skin lesions to prevent cancer spread.
How long does the procedure take?
The excision typically takes about 30 minutes to an hour.
Will there be scarring after the procedure?
Some scarring is possible, but techniques are used to minimize it.
