Overview of CPT Code 21454: Excision of benign skin lesion, face, ears, scalp

Overview of CPT Code 21454: Excision of benign skin lesion, face, ears, scalp

CPT Code 21454 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 21454 is Used?

This code is applicable in various clinical scenarios.

• Presence of a benign skin lesion causing cosmetic concerns.
• Lesions that are symptomatic, such as itching or irritation.
• 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.

• 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 uncertainty about the nature of the lesion.

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 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

Patients should follow specific guidelines before the procedure.

• Avoid blood thinners for a week prior to the procedure.
• Inform the doctor of any allergies or medications.
• Arrive with clean skin, free of lotions or makeup.
• Arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure care is crucial for healing.

• Keep the area clean and dry for the first few days.
• Change the dressing as instructed by the healthcare provider.
• Avoid strenuous activities for at least a week.
• Watch for signs of infection, such as increased redness or discharge.

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

Follow-up is important to ensure proper healing.

• Schedule a follow-up appointment within 1-2 weeks.
• Monitor the healing process and suture removal if necessary.
• Report any unusual symptoms to the healthcare provider.

Alternative Treatments

There are non-surgical options available for some patients.

• Cryotherapy to freeze off the lesion.
• Laser therapy for superficial lesions.
• Topical treatments for certain benign skin conditions.

Home Care Tips

Patients can take steps at home to aid recovery.

• Keep the excision site clean and dry.
• Avoid picking at scabs or lesions.
• Use over-the-counter pain relief as needed.
• Stay hydrated and maintain a healthy diet.

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.
• Consult a dermatologist for any skin concerns.

Billing and Coding Information

CPT Code: 21454

Category: Surgery

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 the insurance plan.

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