Overview of CPT Code 21260: Excision of benign lesion, face, ears, scalp, neck

Overview of CPT Code 21260: Excision of benign lesion, face, ears, scalp, neck

CPT Code 21260 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 21260 is Used?

This procedure is indicated in various clinical scenarios.

• Removal of benign tumors such as lipomas or seborrheic keratosis.
• Excision of cysts that are symptomatic or cosmetically undesirable.
• Management of skin tags or other benign lesions causing irritation.

Symptoms Indicating This Procedure

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

• Visible growths on the skin that are changing in size or appearance.
• Pain or discomfort associated with the lesion.
• Itching or irritation caused by 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.
• Age-related skin changes.

Diagnostic Tests Before Procedure

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

• Physical examination of the lesion.
• Dermatoscopy to assess the characteristics of the lesion.
• 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

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 with clean skin and avoid applying lotions or makeup.

Recovery and Aftercare

Post-procedure care is crucial for optimal healing.

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

Possible Complications

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

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

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Post-Procedure Follow-Up

Follow-up appointments are essential for monitoring recovery.

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

Alternative Treatments

There are non-surgical options for managing benign lesions.

• Topical treatments for superficial lesions.
• Cryotherapy to freeze off certain types of lesions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can take steps at home to aid recovery.

• Keep the area clean and avoid touching it unnecessarily.
• Apply ice packs to reduce swelling if needed.
• Follow all post-operative instructions provided by the healthcare team.

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 wear protective clothing.

Billing and Coding Information

CPT Code: 21260

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.
• 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