Overview of CPT Code 21320: Excision of benign skin lesion, face, ears, scalp, neck

Overview of CPT Code 21320: Excision of benign skin lesion, face, ears, scalp, neck

CPT Code 21320 refers to the surgical excision of benign skin lesions located on the face, ears, scalp, or neck. This procedure is typically performed to remove lesions that are non-cancerous but may cause cosmetic concerns or discomfort.

When CPT Code 21320 is Used?

This code is applicable in various clinical scenarios.

• Removal of benign moles or nevi that are cosmetically undesirable.
• Excision of seborrheic keratosis that may be irritated or inflamed.
• Surgical intervention for dermatofibromas that are symptomatic.
• Excision of lipomas located on the face or neck.

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 color.
• Lesions that cause discomfort or irritation.
• Cosmetic concerns regarding the appearance of skin lesions.
• Symptoms of itching or bleeding from the lesion.

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.
• Age-related skin changes.
• History of skin trauma or irritation.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the diagnosis.

• 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 follows a systematic approach.

• Patient is positioned comfortably and the area is cleaned.
• Local anesthesia is administered to numb the area.
• The surgeon excises the lesion along with a margin of healthy tissue.
• The wound is closed with sutures or adhesive strips.
• Post-operative care instructions are provided.

Preparation for the Procedure

Proper preparation is essential for a smooth procedure.

• Avoid blood thinners and certain medications as advised by the physician.
• Arrive with clean skin, free of lotions or makeup.
• Discuss any allergies or medical conditions with the healthcare provider.

Recovery and Aftercare

Recovery is generally straightforward with proper care.

• Wound care instructions should be followed to prevent infection.
• Pain relief medications may be prescribed as needed.
• Avoid strenuous activities for a few days post-procedure.
• Follow-up appointment should be scheduled to monitor healing.

Possible Complications

While complications are rare, they can occur.

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

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Post-Procedure Follow-Up

Follow-up is crucial for monitoring recovery.

• Typically scheduled within 1-2 weeks post-surgery.
• Assessment of healing and removal of sutures if necessary.
• Discussion of pathology results if a biopsy was performed.

Alternative Treatments

Non-surgical options may be considered in some cases.

• Cryotherapy for superficial lesions.
• Topical treatments for certain benign skin conditions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Patients can take steps to aid recovery at home.

• Keep the area clean and dry.
• Apply any prescribed ointments as directed.
• Monitor for signs of infection such as increased redness or discharge.

Patient Education & Prevention

Education is key to preventing future lesions.

• Regular skin checks for new or changing lesions.
• Use of sunscreen to protect skin from UV damage.
• Avoiding excessive sun exposure, especially during peak hours.

Billing and Coding Information

CPT Code: 21320

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 individual insurance plans.

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
• Cleveland Clinic - Skin Lesions