Overview of CPT Code 11641: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

Overview of CPT Code 11641: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

CPT Code 11641 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 performed to remove cancerous skin growths and prevent the spread of malignancy.

When CPT Code 11641 is Used?

This code is applicable in various clinical scenarios.

• Presence of a malignant melanoma or non-melanoma skin cancer larger than 4.0 cm.
• Lesions that exhibit signs of aggressive growth or invasion.
• Skin cancers located in cosmetically sensitive areas such as the face or neck.

Symptoms Indicating This Procedure

Patients may report several 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.
• A sore that does not heal or keeps recurring.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

• Excessive sun exposure or tanning bed use.
• History of skin cancer in the patient or family.
• Fair skin, light hair, and light eye color.
• Weakened immune system due to conditions or medications.

Diagnostic Tests Before Procedure

Several tests may be conducted to confirm the diagnosis.

• Skin biopsy to determine the type of skin lesion.
• Imaging studies like ultrasound or CT scan if deeper invasion is suspected.
• Lymph node evaluation if metastasis is a concern.

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 excised tissue is sent for pathological examination.
• The wound is closed with sutures or adhesive strips.

Preparation for the Procedure

Proper preparation is essential for a successful procedure.

• Avoid blood thinners and certain medications as advised by the physician.
• Inform the doctor about any allergies or medical conditions.
• Arrive at the facility with clean skin and avoid applying lotions or creams.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Expect some swelling and discomfort; pain relief medication may be prescribed.
• Keep the surgical site clean and dry; follow specific wound care instructions.
• Attend follow-up appointments to monitor healing and remove sutures if necessary.

Possible Complications

While complications are rare, they can occur.

• 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

Regular follow-up is important for monitoring.

• Initial follow-up within 1-2 weeks to check the surgical site.
• Further follow-ups every 3-6 months for the first two years.
• Annual skin examinations thereafter to monitor for new lesions.

Alternative Treatments

There are non-surgical options available.

• 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

Simple home care can aid recovery.

• Keep the area clean and avoid touching it unnecessarily.
• Use ice packs to reduce swelling if needed.
• Follow dietary recommendations to support healing.

Patient Education & Prevention

Education is key to prevention and early detection.

• Regular skin checks for new or changing lesions.
• Use sunscreen with a high SPF to protect against UV rays.
• Avoid tanning beds and seek shade during peak sun hours.

Billing and Coding Information

CPT Code: 11641

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 depending on the complexity.
• Most insurance plans cover the procedure if deemed medically necessary.
• Out-of-pocket costs may apply depending on the insurance policy.

Related CPT Codes

• 11640 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm
• 11642 - 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

References and Sources

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