Overview of CPT Code 17274: Destruction of malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

Overview of CPT Code 17274: Destruction of malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.

CPT Code 17274 refers to the surgical destruction of malignant skin lesions 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 further spread.

When CPT Code 17274 is Used?

This code is applicable in various clinical scenarios.

• Presence of a malignant skin lesion larger than 4.0 cm.
• Lesions that are symptomatic, such as causing pain or discomfort.
• Lesions that have shown signs of growth or change.
• Lesions located in cosmetically sensitive areas requiring careful removal.

Symptoms Indicating This Procedure

Patients may report several symptoms that necessitate this procedure.

• Visible growth on the skin that is changing in size 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

Understanding the causes and risk factors can help in prevention.

• 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.
• Fair skin type that is more susceptible to UV damage.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the diagnosis.

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

Procedure Description

The procedure involves several key steps.

• Patient is positioned comfortably and the area is cleaned.
• Local anesthesia is administered to numb the area.
• The malignant lesion is excised using a scalpel or other surgical instruments.
• The surrounding tissue may be examined to ensure complete removal.
• The wound is closed with sutures or left to heal naturally, depending on the size.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Avoid blood thinners like aspirin or ibuprofen a week prior.
• Inform the doctor about any allergies or medications being taken.
• Arrive with clean skin, free of lotions or creams.
• Arrange for transportation if sedation is used during the procedure.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Expect some swelling and discomfort; ice packs can help.
• Keep the area clean and dry; follow wound care instructions.
• Avoid sun exposure on the healing area to prevent scarring.
• Schedule follow-up appointments to monitor healing and check for recurrence.

Possible Complications

While generally safe, there are potential risks.

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

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring.

• Initial follow-up within 1-2 weeks to check the surgical site.
• Further follow-ups every 3-6 months for the first year.
• Annual skin checks 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 target cancerous cells.

Home Care Tips

Simple tips for effective home care.

• Keep the surgical area clean and dry.
• Use prescribed ointments as directed.
• Monitor for signs of infection, such as increased redness or pus.
• Avoid picking at scabs to promote proper 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.
• Wear protective clothing when outdoors.
• Avoid tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 17274

Category: Surgical Procedures

Common Modifiers:

• -50
• -59
• -76

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $500 to $2,000 depending on complexity.
• Most insurance plans cover the procedure if deemed medically necessary.
• Out-of-pocket costs may apply depending on the insurance plan.

Related CPT Codes

• 17273 - Destruction of benign skin lesions, face, ears, scalp, neck, hands, arms, legs; excised diameter over 4.0 cm.
• 11646 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 17276 - Destruction of benign skin lesions, face, ears, scalp, neck, hands, feet, and genitalia; excised diameter over 4.0 cm.

References and Sources

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