Overview of CPT Code 21490: Excision of benign skin lesion, face, ears, scalp

Overview of CPT Code 21490: Excision of benign skin lesion, face, ears, scalp

CPT Code 21490 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 21490 is Used?

This code is applicable in various clinical scenarios.

• Presence of benign skin lesions such as seborrheic keratosis, dermatofibromas, or lipomas.
• 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 various symptoms that lead to the decision for excision.

• 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.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

• 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 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.
• Dressing is applied to protect the site.

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

Post-procedure care is crucial for healing.

• Expected recovery time is typically 1-2 weeks.
• Keep the area clean and dry, following specific wound care instructions.
• Pain relief medications may be prescribed as needed.
• Monitor for signs of infection such as increased redness or discharge.

Possible Complications

While generally safe, there are potential risks.

• 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.

• Initial follow-up within 1-2 weeks to check the healing process.
• Suture removal may be scheduled if applicable.
• Further appointments as needed based on the pathology report.

Alternative Treatments

There are non-surgical options available.

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

Home Care Tips

Simple tips can aid in recovery.

• Avoid sun exposure on the healing area.
• Do not pick at scabs or the surgical site.
• Follow all wound care instructions provided by the healthcare provider.

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.
• Maintain a healthy lifestyle to support skin health.

Billing and Coding Information

CPT Code: 21490

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