Overview of CPT Code 21100: Excision of benign lesion, face, ears, scalp, neck

Overview of CPT Code 21100: Excision of benign lesion, face, ears, scalp, neck

CPT Code 21100 refers to the surgical excision of benign lesions located on the face, ears, scalp, or neck. This procedure is typically performed to remove non-cancerous growths that may cause cosmetic concerns or discomfort.

When CPT Code 21100 is Used?

This procedure is indicated in various clinical scenarios.

• Removal of benign tumors such as lipomas or seborrheic keratosis.
• Excision of cysts that are symptomatic or cosmetically undesirable.
• Management of skin tags or other benign skin lesions causing irritation.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of this procedure.

• Visible growths on the skin that are changing in size or appearance.
• Pain or discomfort associated with the lesion.
• Itching or irritation caused by the lesion.

Causes and Risk Factors

Several factors can contribute to the development of benign lesions.

• Genetic predisposition to skin growths.
• Sun exposure leading to skin changes.
• Age-related skin changes resulting in benign lesions.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the diagnosis before excision.

• Physical examination of the lesion.
• Dermatoscopy to assess the characteristics of the lesion.
• Biopsy if there is uncertainty about the nature of the lesion.

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 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 to prepare for the excision.

• Avoid blood thinners such as aspirin or ibuprofen a week prior.
• Inform the doctor of any allergies or medical conditions.
• Arrive with clean skin and avoid applying lotions or makeup.

Recovery and Aftercare

Post-procedure care is essential for optimal healing.

• Keep the area clean and dry for the first few days.
• Change dressings as instructed by the healthcare provider.
• Avoid strenuous activities for at least a week.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

• Infection at the site of excision.
• 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 important for monitoring recovery.

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

Alternative Treatments

There are non-surgical options for managing benign lesions.

• Cryotherapy to freeze off the lesion.
• Topical treatments for superficial lesions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can follow these tips to aid recovery at home.

• Apply ice packs to reduce swelling in the first 24 hours.
• Take prescribed pain medications as needed.
• Avoid sun exposure on the healing area.

Patient Education & Prevention

Educating patients can help prevent recurrence.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect skin from UV damage.
• Maintain a healthy lifestyle to support skin health.

Billing and Coding Information

CPT Code: 21100

Category: Surgery

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 $200 to $1,500 depending on complexity.
• Most insurance plans cover the procedure if deemed medically necessary.
• Out-of-pocket costs may apply based on the 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.
• 11403 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.
• 11404 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions
• Cleveland Clinic - Skin Growths