Overview of CPT Code 15964: Excision of skin lesion, face, ears, eyelids, scalp, neck

Overview of CPT Code 15964: Excision of skin lesion, face, ears, eyelids, scalp, neck

CPT Code 15964 refers to the surgical excision of skin lesions located on the face, ears, eyelids, scalp, or neck. This procedure is typically performed to remove abnormal growths, such as tumors or cysts, that may be benign or malignant.

When CPT Code 15964 is Used?

This procedure is indicated in various clinical scenarios.

• Presence of a suspicious skin lesion that requires biopsy.
• Removal of benign skin lesions causing discomfort or cosmetic concerns.
• Excision of malignant skin lesions to prevent further spread.
• Treatment of recurrent skin lesions that have previously been excised.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the need for this procedure.

• Visible growth or change in a mole or skin lesion.
• Itching, pain, or tenderness in the area of the lesion.
• Bleeding or oozing from the lesion.
• Changes in color or texture of the skin lesion.

Causes and Risk Factors

Several factors can contribute to the development of skin lesions.

• Sun exposure leading to skin damage.
• Genetic predisposition to skin cancers.
• History of skin conditions such as acne or eczema.
• Weakened immune system due to illness or medication.

Diagnostic Tests Before Procedure

Certain tests may be conducted to assess the lesion before excision.

• Skin biopsy to determine the nature of the lesion.
• Dermatoscopy for detailed examination of the skin.
• Imaging studies if deeper tissue involvement is suspected.

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.
• The surgeon makes an incision around the lesion.
• The lesion is carefully excised along with a margin of healthy tissue.
• The incision is closed with sutures or adhesive strips.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Avoid blood-thinning medications for a week prior.
• Inform the doctor of any allergies or medical conditions.
• Arrive with clean skin, free of lotions or makeup.
• Arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Keep the surgical site clean and dry.
• Change dressings as instructed by the healthcare provider.
• Avoid strenuous activities for at least a week.
• Take prescribed pain medications as needed.

Possible Complications

While generally safe, there are potential risks involved.

• Infection at the surgical site.
• Excessive bleeding during or after the procedure.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion if not completely excised.

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Post-Procedure Follow-Up

Follow-up appointments are essential for monitoring recovery.

• Schedule a follow-up visit within 1-2 weeks post-surgery.
• Monitor for signs of infection or complications.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

There are non-surgical options for managing skin lesions.

• Topical treatments for benign lesions.
• Cryotherapy to freeze off certain skin growths.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can follow these tips for better recovery.

• Keep the area moisturized with recommended ointments.
• Avoid sun exposure on the healing site.
• Do not pick at scabs or sutures to prevent scarring.
• Stay hydrated and maintain a balanced diet.

Patient Education & Prevention

Educating patients can help prevent future lesions.

• Regular skin checks for early detection of changes.
• Use sunscreen to protect against UV damage.
• Avoid tanning beds and excessive sun exposure.
• Report any new or changing lesions to a healthcare provider.

Billing and Coding Information

CPT Code: 15964

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $300 to $1,500.
• Insurance may cover the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the patient's insurance plan.

Related CPT Codes

• 11400 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11401 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11402 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11600 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11601 - 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.

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions