Overview of CPT Code 21240: Excision of benign lesion, face, ears, scalp, neck

Overview of CPT Code 21240: Excision of benign lesion, face, ears, scalp, neck

CPT Code 21240 refers to the surgical excision of benign lesions 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 21240 is Used?

This code is applicable in various clinical scenarios.

• Presence of a benign tumor or cyst causing discomfort or cosmetic issues.
• Lesions that are growing or changing in appearance.
• Skin tags or moles that are bothersome to the patient.
• Lesions that require histological examination to rule out malignancy.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of this procedure.

• Visible growths on the skin that are changing in size or color.
• Pain or tenderness in the area of the lesion.
• Itching or irritation associated with the lesion.
• Bleeding or oozing from the lesion.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

• Genetic predisposition to skin growths.
• Sun exposure leading to skin changes.
• Previous skin injuries or infections.
• Certain skin conditions like 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 malignancy is suspected.

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 before the procedure if sedation is planned.
• Arrive with clean skin and avoid applying lotions or makeup.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Expect some swelling and discomfort for a few days.
• Keep the area clean and dry; follow wound care instructions.
• Take prescribed pain medications as needed.
• Avoid strenuous activities for a week or as advised.

Possible Complications

While generally safe, there are potential risks.

• Infection at the site of excision.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion.
• Allergic reactions to anesthesia.

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Post-Procedure Follow-Up

Follow-up is important to monitor healing.

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

Alternative Treatments

There are non-surgical options available.

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

Home Care Tips

Patients can follow these tips for better recovery.

• Keep the surgical site clean and dry.
• Avoid picking at the scab or incision.
• Use sunscreen on the area once healed to prevent discoloration.

Patient Education & Prevention

Educating patients can help prevent future lesions.

• 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: 21240

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.
• Out-of-pocket costs may apply based on the insurance plan.

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