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Overview of CPT Code 11643: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

Overview of CPT Code 11643: Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

CPT Code 11643 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 11643 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 or color.
  • Bleeding or oozing from the lesion.
  • Itching or pain in the area of the lesion.

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 confirm malignancy.
  • Imaging studies like ultrasound or CT scan if deeper invasion 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 staples, and a dressing is applied.

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 creams.

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.
  • Take prescribed pain medications as needed.

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 to check healing.
  • Regular skin checks every 6-12 months to monitor for new lesions.

Alternative Treatments

There are non-surgical options available.

  • Topical chemotherapy for superficial skin cancers.
  • Cryotherapy to freeze off small lesions.

Home Care Tips

Simple tips can aid in recovery.

  • Avoid sun exposure on the healing area.
  • Use sunscreen to protect the skin.
  • Monitor for signs of infection such as increased redness or pus.

Patient Education & Prevention

Education is key to preventing skin cancer.

  • Regular skin checks for new or changing lesions.
  • Use sunscreen daily and wear protective clothing.
  • Avoid tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 11643

Category: Surgical Procedures

Common Modifiers:

  • 25 - Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure.

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.

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.

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