Overview of CPT Code 21385: Excision of benign skin lesion, face, ears, scalp

Overview of CPT Code 21385: Excision of benign skin lesion, face, ears, scalp

CPT Code 21385 refers to the surgical excision of benign skin lesions located on the face, ears, or scalp. This procedure is performed to remove non-cancerous growths that may cause cosmetic concerns or discomfort.

When CPT Code 21385 is Used?

This procedure is indicated in various clinical scenarios.

• Presence of benign skin lesions such as seborrheic keratosis, dermatofibromas, or lipomas.
• Lesions that are symptomatic, causing pain or irritation.
• Cosmetic concerns regarding the appearance of skin lesions.
• Lesions that have changed in size, shape, or color, warranting removal for further evaluation.

Symptoms Indicating This Procedure

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

• Visible skin growths on the face, ears, or scalp.
• Itching or irritation at the site of the lesion.
• Bleeding or oozing from the lesion.
• Changes in the appearance of the lesion, such as color or size.

Causes and Risk Factors

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

• Genetic predisposition to skin growths.
• Sun exposure leading to skin changes.
• Age-related skin changes.
• Previous skin injuries or trauma.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the need for excision.

• Physical examination of the lesion.
• Dermatoscopy to assess the characteristics of the lesion.
• Biopsy may be performed 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 excises the lesion along with a margin of healthy tissue.
• The wound is closed with sutures or adhesive strips.
• Dressing is applied to protect the site.

Preparation for the Procedure

Proper preparation can enhance the success of the procedure.

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

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Keep the area clean and dry.
• Change the dressing 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 involved.

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

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring recovery.

• Initial follow-up within one week to check the healing process.
• Further follow-ups as needed based on the pathology report.
• Monitoring for any signs of recurrence or complications.

Alternative Treatments

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

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

Home Care Tips

Simple home care can aid in recovery.

• Keep the excision site clean and dry.
• Avoid picking at the wound.
• Use over-the-counter pain relief as needed.

Patient Education & Prevention

Educating patients can help in prevention and early detection.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect skin from UV damage.
• Seek medical advice for any concerning skin changes.

Billing and Coding Information

CPT Code: 21385

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.
• Check with your insurance provider for specific coverage details.

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.
• 11404 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm.

References and Sources

• American Academy of Dermatology
• Mayo Clinic - Skin Lesions
• Cleveland Clinic - Skin Lesions