Overview of CPT Code 21154: Excision of benign lesion, face, ears, scalp, neck

Overview of CPT Code 21154: Excision of benign lesion, face, ears, scalp, neck

CPT Code 21154 refers to the surgical excision of a benign lesion 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 21154 is Used?

This code is applicable in various clinical scenarios.

• Removal of a benign tumor or cyst that is causing discomfort.
• Excision of a lesion for cosmetic improvement.
• Lesions that are suspected to be precursors to skin cancer.
• Recurring lesions that have previously been treated.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the decision for excision.

• Visible growth or lump on the skin.
• Itching or irritation in the area of the lesion.
• Bleeding or oozing from the lesion.
• Changes in the appearance of the lesion over time.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

• Genetic predisposition to skin lesions.
• Sun exposure leading to skin changes.
• Previous skin injuries or infections.
• Certain skin conditions like seborrheic keratosis.

Diagnostic Tests Before Procedure

Several tests may be conducted to confirm the need for excision.

• Physical examination of the lesion.
• Dermatoscopy to assess the lesion's characteristics.
• Biopsy if malignancy is suspected.

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

Proper preparation is essential for a smooth procedure.

• Avoid blood thinners and certain medications as advised by the doctor.
• Do not eat or drink for a specified period before the procedure.
• Arrange for transportation home post-procedure if sedation is used.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Keep the surgical site clean and dry.
• Change dressings as instructed by the healthcare provider.
• Avoid strenuous activities for a few days.
• Take prescribed pain medications as needed.

Possible Complications

While complications are rare, they can occur.

• Infection at the surgical site.
• Excessive bleeding.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up is important to monitor healing.

• Schedule a follow-up appointment within one to two weeks.
• Monitor for signs of infection or complications.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

There are non-surgical options available.

• Topical treatments for superficial lesions.
• Cryotherapy to freeze off benign growths.
• Laser therapy for cosmetic concerns.

Home Care Tips

Simple tips can aid in recovery.

• Keep the area moisturized with recommended ointments.
• Avoid picking at the wound.
• Wear sunscreen to protect the healing skin.

Patient Education & Prevention

Education can help prevent future lesions.

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

Billing and Coding Information

CPT Code: 21154

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.

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 Cancer