Overview of CPT Code 11640: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm

CPT Code 11640 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 skin growths and prevent the spread of malignancy.

When CPT Code 11640 is Used?

This code is applicable in various clinical scenarios, including:

Presence of a malignant melanoma or non-melanoma skin cancer larger than 4.0 cm.
Suspicion of skin cancer based on clinical examination or biopsy results.
Need for complete removal of cancerous tissue to ensure clear margins.

Symptoms Indicating This Procedure

Patients may report the following symptoms that necessitate this procedure:

A growing or changing mole or skin lesion.
Itching, bleeding, or crusting of the lesion.
Pain or discomfort in the area of the lesion.

Causes and Risk Factors

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

Excessive sun exposure or history of sunburns.
Family history of skin cancer.
Weakened immune system due to conditions or medications.

Diagnostic Tests Before Procedure

Prior to the excision, the following diagnostic tests may be conducted:

Skin biopsy to confirm malignancy.
Imaging studies if deeper tissue involvement 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, ensuring clear margins.
The lesion is excised along with a margin of healthy tissue.
The wound is closed with sutures or adhesive strips.

Preparation for the Procedure

Patients should follow these preparation steps:

Avoid blood-thinning medications for a week prior to the procedure.
Inform the physician of any allergies or medical conditions.
Arrange for transportation home post-procedure if sedation is used.

Recovery and Aftercare

Post-procedure recovery typically involves:

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 include:

Infection at the surgical site.
Scarring or changes in skin pigmentation.
Recurrence of the malignant lesion.

Secure, compliant, and built for trust

HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.

Learn more

Post-Procedure Follow-Up

Follow-up care is essential for monitoring recovery:

Schedule a follow-up appointment within 1-2 weeks to assess healing.
Regular skin checks to monitor for new lesions or changes.

Alternative Treatments

Non-surgical options may include:

Topical chemotherapy for superficial skin cancers.
Cryotherapy for small lesions.
Photodynamic therapy for certain types of skin cancer.

Home Care Tips

Patients can follow these tips for effective home care:

Avoid sun exposure on the surgical site until healed.
Use sunscreen to protect the area once healed.
Monitor for signs of infection, such as increased redness or discharge.

Patient Education & Prevention

To prevent skin cancer and recurrence, patients should consider:

Regular skin examinations by a dermatologist.
Use of broad-spectrum sunscreen daily.
Avoiding tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 11640

Category: Surgical Procedures

Common Modifiers:

50 (bilateral procedure)
59 (distinct procedural service)

Average Cost and Insurance Coverage

The cost for this procedure can vary widely:

Average cost ranges from $1,500 to $3,000 depending on location and complexity.
Most insurance plans cover excision of malignant lesions, but pre-authorization may be required.