Overview of CPT Code 17286:destruction-of-malignant-skin-lesion-face-ears-scalp-neck-excised-diameter-over-4-0-cm

Overview of CPT Code 17286:destruction-of-malignant-skin-lesion-face-ears-scalp-neck-excised-diameter-over-4-0-cm

CPT Code 17286 refers to the procedure for the 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 skin growths and prevent further spread.

When CPT Code 17286 is Used?

This code is applicable in various clinical scenarios, including:

• Presence of a malignant skin lesion larger than 4.0 cm.
• Lesions that are suspected to be cancerous based on clinical examination.
• Need for surgical intervention to prevent metastasis.
• Patient history of skin cancer requiring excision of new lesions.

Symptoms Indicating This Procedure

Patients may report the following symptoms that necessitate this procedure:

• Visible growths on the skin that change in size or color.
• Ulceration or bleeding from the lesion.
• Itching or discomfort in the affected area.
• History of skin cancer or precancerous lesions.

Causes and Risk Factors

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

• Excessive sun exposure leading to skin damage.
• Family history of skin cancer.
• Weakened immune system due to conditions like HIV or medications.
• Previous skin cancer diagnoses.

Diagnostic Tests Before Procedure

Before proceeding with the destruction of the lesion, the following diagnostic tests may be conducted:

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

Procedure Description

The procedure involves several key steps:

• Patient is positioned comfortably and the area is cleaned.
• Local anesthesia is administered to minimize discomfort.
• The malignant lesion is excised using surgical instruments.
• The surrounding tissue may be cauterized to prevent bleeding.
• The site is closed with sutures or left to heal naturally.

Preparation for the Procedure

Patients should follow these steps to prepare for the procedure:

• Avoid blood-thinning medications for a week prior.
• Discuss any allergies with the healthcare provider.
• Arrive with clean skin, free of lotions or makeup.
• Have a responsible adult accompany you for post-procedure care.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Wound care instructions to keep the site clean and dry.
• Pain management with prescribed or over-the-counter medications.
• Monitoring for signs of infection such as increased redness or discharge.
• Follow-up appointments to assess healing and remove sutures if necessary.

Possible Complications

While generally safe, the procedure may have risks, including:

• Infection at the surgical site.
• Scarring or changes in skin pigmentation.
• Recurrence of the malignant lesion.
• Delayed healing or complications from anesthesia.

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery:

• Initial follow-up within 1-2 weeks post-procedure.
• Regular skin checks every 3-6 months thereafter.
• Immediate consultation if any concerning symptoms arise.

Alternative Treatments

For patients who may not undergo surgery, alternative options include:

• Topical chemotherapy agents for superficial lesions.
• Cryotherapy to freeze and destroy abnormal cells.
• Photodynamic therapy using light to target cancerous cells.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the surgical site clean and dry.
• Avoid sun exposure on the healing area.
• Use prescribed ointments as directed.
• Monitor for any signs of complications.

Patient Education & Prevention

To prevent future lesions, patients should consider:

• Regular skin checks for early detection of changes.
• Use of sunscreen with high SPF to protect against UV rays.
• Avoiding tanning beds and excessive sun exposure.
• Maintaining a healthy lifestyle to support skin health.

Billing and Coding Information

CPT Code: 17286

Category: Surgical Procedures

Common Modifiers:

• -50
• -59
• -76

Average Cost and Insurance Coverage

The cost for this procedure can vary widely:

• Average cost ranges from $1,500 to $3,000.
• Insurance may cover the procedure if deemed medically necessary.
• Patients should verify coverage with their insurance provider.

Related CPT Codes

• 17280 - Destruction of benign skin lesion, excised
• 17281 - Destruction of benign skin lesions, face, ears, scalp, neck, hands, feet, and genitalia; excised diameter over 4.0 cm.
• 17282 - Destruction of benign skin lesion, face, ears, scalp
• 11606 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11604 - 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
• National Cancer Institute
• Mayo Clinic - Skin Cancer