Overview of CPT Code 21420: Excision of benign skin lesion, face, ears, scalp, neck

Overview of CPT Code 21420: Excision of benign skin lesion, face, ears, scalp, neck

CPT Code 21420 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 21420 is Used?

This code is applicable in various clinical scenarios.

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

Symptoms Indicating This Procedure

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

• Visible skin lesions that are raised or discolored.
• Itching or irritation at the site of the lesion.
• Bleeding or oozing from the lesion.
• Changes in the texture or appearance of 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.
• Previous skin injuries or conditions.

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 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 can enhance the procedure's success.

• 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

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

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Post-Procedure Follow-Up

Follow-up is crucial for monitoring recovery.

• Typically scheduled 1-2 weeks after the procedure.
• Assessment of healing and removal of sutures if applicable.
• Discussion of pathology results if a biopsy was performed.

Alternative Treatments

Non-surgical options may be considered in some cases.

• Cryotherapy to freeze off the lesion.
• Topical treatments for superficial lesions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Simple home care can aid in recovery.

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

Patient Education & Prevention

Education is key to preventing future lesions.

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

Billing and Coding Information

CPT Code: 21420

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 $1,000 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

• 11420 - Excision, benign skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm
• 11421 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm
• 11422 - Excision, benign skin lesion, face, ears, scalp; excised diameter over 4.0 cm
• 11423 - 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