Overview of CPT Code 21200: Excision of benign lesion, face, ears, scalp, neck

Overview of CPT Code 21200: Excision of benign lesion, face, ears, scalp, neck

CPT Code 21200 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 21200 is Used?

This procedure is indicated in various clinical scenarios.

• Presence of a benign lesion causing cosmetic concerns.
• Lesions that are symptomatic, such as causing irritation or discomfort.
• Lesions that have changed in appearance or size.
• Need for histological examination of the lesion.

Symptoms Indicating This Procedure

Patients may report several symptoms that warrant this procedure.

• Visible growth on the skin that is changing in size or color.
• Itching or irritation at the site of the lesion.
• Bleeding or oozing from the lesion.
• Pain or discomfort associated with 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.
• Previous skin injuries or infections.
• Certain skin conditions, such as seborrheic keratosis.

Diagnostic Tests Before Procedure

Before the excision, certain diagnostic tests may be performed.

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

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 before the procedure.

• Avoid blood thinners and certain medications as advised by the physician.
• Do not eat or drink for a specified period if sedation is planned.
• Arrive at the facility with clean skin, free of lotions or makeup.

Recovery and Aftercare

Post-procedure care is essential for optimal recovery.

• Keep the surgical site clean and dry.
• Change dressings as instructed by the healthcare provider.
• Avoid strenuous activities for a few days.
• Follow up for suture removal if applicable.

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

Follow-up care is crucial for monitoring recovery.

• Schedule a follow-up appointment within 1-2 weeks post-procedure.
• Monitor for signs of infection or complications.
• Discuss pathology results if the lesion was sent for analysis.

Alternative Treatments

There are non-surgical options for managing benign lesions.

• Topical treatments for superficial lesions.
• Cryotherapy to freeze off the lesion.
• Laser therapy for certain types of skin growths.

Home Care Tips

Patients can follow these tips for effective home care.

• Keep the area clean and avoid touching it unnecessarily.
• Apply any prescribed ointments as directed.
• Monitor for any changes in the surgical site.

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 and tanning beds.

Billing and Coding Information

CPT Code: 21200

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

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 policy.

Related CPT Codes

• 11100 - Biopsy of skin, single lesion
• 11101 - Biopsy of skin, excisional, single lesion
• 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.

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions