Overview of CPT Code 21122: Removal of benign tumor, face or scalp

Overview of CPT Code 21122: Removal of benign tumor, face or scalp

CPT Code 21122 refers to the surgical removal of a benign tumor located on the face or scalp. This procedure is typically performed by a dermatologist or a plastic surgeon and is indicated when a tumor is causing discomfort, cosmetic concerns, or has the potential for complications.

When CPT Code 21122 is Used?

This code is applicable in various clinical scenarios, including:

• Presence of a benign tumor on the face or scalp that is symptomatic.
• Tumors that are growing or changing in appearance.
• Lesions that are causing pain or discomfort.
• Cosmetic concerns regarding the appearance of the tumor.

Symptoms Indicating This Procedure

Patients may report the following symptoms:

• Visible growth on the face or scalp.
• Pain or tenderness in the area of the tumor.
• Itching or irritation around the tumor.
• Changes in the color or texture of the tumor.

Causes and Risk Factors

Several factors may contribute to the development of benign tumors on the face or scalp.

• Genetic predisposition to skin growths.
• Previous skin injuries or trauma.
• Sun exposure leading to skin changes.
• Certain skin conditions, such as seborrheic keratosis.

Diagnostic Tests Before Procedure

Before proceeding with the removal, the following diagnostic tests may be conducted:

• Physical examination of the tumor.
• Dermatoscopy to assess the characteristics of the lesion.
• Biopsy if there is any suspicion of malignancy.

Procedure Description

The removal of a benign tumor typically follows these 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 tumor.
• The tumor is carefully excised along with a margin of healthy tissue.
• The incision is closed with sutures or adhesive strips.
• The area is bandaged to protect the wound.

Preparation for the Procedure

Patients should follow these steps to prepare for the procedure:

• Avoid blood-thinning medications for a week prior to surgery.
• Discuss any allergies with the healthcare provider.
• Arrive at the facility with a clean face and scalp.
• Have a responsible adult accompany you for post-procedure care.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Resting for the first 24 hours after the procedure.
• Keeping the surgical site clean and dry.
• Changing the dressing as instructed by the healthcare provider.
• Taking prescribed pain medications as needed.

Possible Complications

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

• Infection at the surgical site.
• Scarring or changes in skin texture.
• Bleeding or hematoma formation.
• Recurrence of the tumor.

Secure, compliant, and built for trust

HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.

Learn more

Post-Procedure Follow-Up

Follow-up care is essential for monitoring recovery:

• Schedule a follow-up appointment within 1-2 weeks post-surgery.
• Monitor the surgical site for signs of infection.
• Discuss any concerns or complications with the healthcare provider.

Alternative Treatments

In some cases, non-surgical options may be considered:

• Observation if the tumor is asymptomatic and stable.
• Cryotherapy to freeze and reduce the tumor.
• Laser therapy for superficial lesions.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the area clean and avoid touching it.
• Apply ice packs to reduce swelling if needed.
• Avoid sun exposure on the healing site.
• Follow all post-operative instructions provided by the surgeon.

Patient Education & Prevention

Educating patients on prevention can help reduce recurrence:

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect the skin from UV damage.
• Avoid excessive sun exposure, especially during peak hours.
• Consult a dermatologist for any concerns about skin growths.

Billing and Coding Information

CPT Code: 21122

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• RT - Right side
• LT - Left side

Average Cost and Insurance Coverage

The cost of the procedure can vary widely:

• Average cost ranges from $500 to $2,000 depending on complexity.
• Most insurance plans cover the procedure if deemed medically necessary.
• Patients should verify coverage with their insurance provider.

Related CPT Codes

• 21121 - Excision of benign lesion, face, ears, scalp, neck
• 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.
• 12001 - Simple Repair of Laceration, Face, Ears, Eyelids, Nose

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Tumors
• Cleveland Clinic - Skin Cancer and Tumors