Overview of CPT Code 21343: Excision of benign lesion, face, ears, scalp, neck

Overview of CPT Code 21343: Excision of benign lesion, face, ears, scalp, neck

CPT Code 21343 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 21343 is Used?

This code is applicable 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.
• Patient request for removal of a benign lesion for aesthetic reasons.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of 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.
• Discomfort or pain associated with the lesion.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention and early detection.

• Genetic predisposition to skin lesions.
• 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

Proper preparation can enhance the success of 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 at the facility with clean skin, free of 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.
• Take prescribed pain medications as needed.

Possible Complications

While complications are rare, they can occur.

• 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 appointments are essential for monitoring recovery.

• Initial follow-up within one week to assess healing.
• Suture removal if applicable, typically within 7-14 days.
• Long-term follow-up to monitor for recurrence.

Alternative Treatments

There are non-surgical options available for managing benign lesions.

• Cryotherapy to freeze off the lesion.
• Laser therapy for targeted removal.
• Topical treatments for certain types of benign lesions.

Home Care Tips

Simple home care can aid in recovery.

• Keep the area clean and avoid touching it.
• Apply ice packs to reduce swelling if needed.
• Monitor for signs of infection, such as increased redness or discharge.

Patient Education & Prevention

Educating patients can help prevent future lesions.

• Use sunscreen to protect skin from UV damage.
• Regular skin checks for early detection of changes.
• Avoid excessive sun exposure and tanning beds.

Billing and Coding Information

CPT Code: 21343

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 $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

• 21345 - Repair of facial fracture
• 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.
• 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 Cancer