Overview of CPT Code 21172: Injection of therapeutic substance into lesion

Overview of CPT Code 21172: Injection of therapeutic substance into lesion

CPT Code 21172 refers to the injection of a therapeutic substance directly into a lesion, typically for the treatment of conditions such as tumors or cysts. This procedure is often performed to reduce the size of the lesion, alleviate symptoms, or improve cosmetic appearance.

When CPT Code 21172 is Used?

This code is applicable in various clinical scenarios.

• Injection of corticosteroids into keloids or hypertrophic scars.
• Injection of sclerosing agents for the treatment of vascular malformations.
• Injection of local anesthetics for pain management in lesions.
• Injection of chemotherapeutic agents for malignant tumors.

Symptoms Indicating This Procedure

Patients may present with various symptoms that warrant this procedure.

• Pain or discomfort in the area of the lesion.
• Visible swelling or growth of the lesion.
• Itching or irritation around the lesion.
• Changes in color or texture of the skin over the lesion.

Causes and Risk Factors

Understanding the underlying causes can help in managing lesions effectively.

• Genetic predisposition to certain skin conditions.
• Previous trauma or injury to the skin.
• Chronic inflammatory conditions.
• Exposure to certain environmental factors or irritants.

Diagnostic Tests Before Procedure

Certain tests may be conducted to guide the procedure.

• Ultrasound imaging to assess the size and depth of the lesion.
• Biopsy to determine the nature of the lesion.
• MRI or CT scans for deeper lesions or tumors.
• Blood tests to check for underlying conditions.

Procedure Description

The procedure involves several key steps.

• Patient is positioned comfortably and the area is cleaned.
• Local anesthesia may be administered to minimize discomfort.
• A syringe is prepared with the therapeutic substance.
• The substance is injected directly into the lesion.
• The injection site is bandaged if necessary.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Inform the physician about any allergies or medications.
• Avoid blood thinners or anti-inflammatory medications prior to the procedure.
• Arrive with clean skin, free of lotions or creams.
• Discuss any concerns or questions with the healthcare provider.

Recovery and Aftercare

Post-procedure care is essential for optimal recovery.

• Rest for the remainder of the day after the procedure.
• Keep the injection site clean and dry.
• Apply ice to reduce swelling if necessary.
• Follow up with the healthcare provider as instructed.

Possible Complications

While generally safe, there are potential risks involved.

• Infection at the injection site.
• Allergic reaction to the injected substance.
• Bleeding or bruising at the injection site.
• Temporary pain or discomfort following the injection.

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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 any signs of infection or adverse reactions.
• Assess the effectiveness of the treatment during follow-up.
• Discuss any ongoing symptoms or concerns with the provider.

Alternative Treatments

There are various non-surgical options available.

• Topical treatments such as corticosteroid creams.
• Cryotherapy for freezing lesions.
• Laser therapy for cosmetic improvement.
• Observation and monitoring for benign lesions.

Home Care Tips

Patients can take steps to aid recovery at home.

• Avoid strenuous activities for a few days post-injection.
• Keep the area moisturized if recommended by the physician.
• Use over-the-counter pain relief as needed.
• Stay hydrated and maintain a healthy diet.

Patient Education & Prevention

Educating patients can help prevent recurrence.

• Understand the nature of the lesion and its treatment options.
• Recognize early signs of complications.
• Maintain regular skin checks for new or changing lesions.
• Adopt sun protection measures to prevent skin damage.

Billing and Coding Information

CPT Code: 21172

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 $600 per injection.
• Insurance may cover the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the patient's insurance plan.
• Pre-authorization may be required by some insurance providers.

Related CPT Codes

• 20610 - 'Arthrocentesis, aspiration of joint'
• 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
• 11900 - Removal of skin lesion, excised
• 11901 - Removal of Implantable Contraceptive Device

References and Sources

• American Medical Association
• Centers for Medicare & Medicaid Services
• National Institutes of Health