Overview of CPT Code 11623: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

Overview of CPT Code 11623: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

CPT Code 11623 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 11623 is Used?

This code is applicable in various clinical scenarios, including:

• Presence of a malignant skin lesion larger than 4.0 cm.
• Lesions that exhibit signs of aggressive behavior or rapid growth.
• Lesions located in cosmetically sensitive areas such as the face or neck.
• Prior unsuccessful treatments for skin cancer.

Symptoms Indicating This Procedure

Patients may report the following symptoms that necessitate this procedure:

• A noticeable growth on the skin that changes in size, shape, or color.
• Bleeding or oozing from the lesion.
• Itching or irritation around the lesion.
• Pain or tenderness in the area of the lesion.

Causes and Risk Factors

Several factors can contribute to the development of malignant skin lesions:

• Excessive sun exposure leading to skin damage.
• History of skin cancer in the patient or family.
• Weakened immune system due to conditions like HIV or medications.
• Exposure to certain chemicals or radiation.

Diagnostic Tests Before Procedure

Before proceeding with the excision, the following diagnostic tests may be conducted:

• Skin biopsy to confirm malignancy.
• Imaging studies such as ultrasound or MRI if deeper tissue involvement is suspected.
• Blood tests to assess overall health and immune function.

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.
• The surgeon excises the malignant lesion along with a margin of healthy tissue.
• The excised tissue is sent for pathological examination.
• The wound is closed with sutures or adhesive strips.

Preparation for the Procedure

Patients should follow these preparatory steps:

• Avoid blood-thinning medications such as aspirin or ibuprofen for at least a week prior.
• Discuss any allergies or medical conditions with the healthcare provider.
• Arrive at the facility with clean skin and avoid applying lotions or creams.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Resting for the first 24 hours 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, this procedure may have risks, including:

• Infection at the surgical site.
• Excessive bleeding or hematoma formation.
• Scarring or changes in skin pigmentation.
• Recurrence of the malignant 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 check the surgical site.
• Discuss pathology results and any further treatment if necessary.
• Regular skin checks to monitor for new lesions or changes.

Alternative Treatments

In some cases, non-surgical options may be considered:

• Topical chemotherapy for superficial skin cancers.
• Cryotherapy to freeze and destroy abnormal cells.
• Photodynamic therapy using light to treat certain skin cancers.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the surgical area clean and dry.
• Avoid sun exposure on the healing site.
• Use sunscreen to protect the area once healed.
• Monitor for signs of infection such as increased redness or discharge.

Patient Education & Prevention

Educating patients on prevention is crucial:

• Regular skin checks for early detection of skin changes.
• Use of sunscreen and protective clothing when outdoors.
• Avoiding tanning beds and excessive sun exposure.
• Promptly reporting any new or changing skin lesions to a healthcare provider.

Billing and Coding Information

CPT Code: 11623

Category: Surgical Procedures

Common Modifiers:

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

Average Cost and Insurance Coverage

The cost of the procedure can vary widely:

• Average cost ranges from $1,500 to $3,000 depending on the complexity.
• Most insurance plans cover excision of malignant lesions.
• Patients should verify coverage details with their insurance provider.

Related CPT Codes

• 11622 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm
• 11620 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11621 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11406 - Excision, benign skin lesion; face, ears, scalp, neck, excised diameter over 4.0 cm
• 11624 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

References and Sources

• American Academy of Dermatology
• National Cancer Institute
• Mayo Clinic - Skin Cancer