Overview of CPT Code 21147: Excision of benign skin lesion, face, ears, scalp, neck

Overview of CPT Code 21147: Excision of benign skin lesion, face, ears, scalp, neck

CPT Code 21147 refers to the surgical excision of benign skin lesions located on the face, ears, scalp, or neck. This procedure is typically performed to remove lesions that are non-cancerous but may cause cosmetic concerns or discomfort.

When CPT Code 21147 is Used?

This code is applicable in various clinical scenarios.

• Removal of benign moles or nevi that are cosmetically unappealing.
• Excision of seborrheic keratosis that may be irritated or inflamed.
• Surgical intervention for lipomas located on the face or neck.
• Excision of dermatofibromas that are symptomatic or bothersome.

Symptoms Indicating This Procedure

Patients may present with various symptoms prompting the need for excision.

• Visible skin lesions that are growing or changing in appearance.
• Lesions that cause discomfort or irritation.
• Cosmetic concerns regarding the appearance of facial or neck lesions.
• Itching or tenderness associated with the lesion.

Causes and Risk Factors

Several factors can contribute to the development of benign skin lesions.

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

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the nature of the lesion.

• Physical examination of the lesion by a dermatologist.
• Dermatoscopy to assess the characteristics of the lesion.
• Biopsy may be performed if there is uncertainty about the lesion's nature.

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 to the procedure.
• Inform the surgeon 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 essential for optimal healing.

• Keep the surgical site clean and dry.
• Change dressings as instructed by the healthcare provider.
• Avoid strenuous activities for at least a week.
• Follow up for suture removal as directed.

Possible Complications

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

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

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Post-Procedure Follow-Up

Monitoring after the procedure is crucial.

• Schedule a follow-up appointment within 1-2 weeks.
• Monitor for signs of infection or unusual changes.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

Non-surgical options may be considered in certain cases.

• Cryotherapy for superficial lesions.
• Topical treatments for benign skin growths.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can take steps to aid recovery at home.

• Keep the area clean and avoid touching it.
• Use over-the-counter pain relief as needed.
• Apply ice packs to reduce swelling if necessary.
• Follow all aftercare instructions provided by the surgeon.

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.
• Avoid excessive sun exposure, especially during peak hours.
• Maintain a healthy lifestyle to support skin health.

Billing and Coding Information

CPT Code: 21147

Category: Surgical Procedures

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.
• Insurance may cover the procedure if deemed medically necessary.
• Check with your insurance provider for specific coverage details.

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.
• 11406 - Excision, benign skin lesion; face, ears, scalp, neck, excised diameter over 4.0 cm

References and Sources

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