Overview of CPT Code 21725: Excision of benign skin lesion

Overview of CPT Code 21725: Excision of benign skin lesion

CPT Code 21725 refers to the surgical excision of a benign skin lesion, which is a non-cancerous growth on the skin. This procedure is performed to remove lesions that may cause discomfort, cosmetic concerns, or have the potential for changes that could lead to malignancy.

When CPT Code 21725 is Used?

This code is applicable in various clinical scenarios.

• Removal of a benign mole that is causing irritation or discomfort.
• Excision of a dermatofibroma that is unsightly or bothersome.
• Surgical removal of a seborrheic keratosis that is changing in appearance.
• Excision of a lipoma that is growing or causing pain.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the decision for excision.

• Itching or irritation at the site of the lesion.
• Changes in the color or size of the lesion.
• Bleeding or oozing from the lesion.
• Pain or discomfort 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.
• 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 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 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 like aspirin a week before the procedure.
• Inform the doctor about any allergies or medications.
• Arrive with clean skin, free of lotions or creams.
• Arrange for someone to drive you home post-procedure.

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 pus.

Possible Complications

While complications are rare, they can occur.

• Infection at the site of excision.
• Scarring or changes in skin texture.
• Bleeding during or after the procedure.
• Allergic reaction to anesthesia.

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Post-Procedure Follow-Up

Follow-up is essential to monitor healing.

• Schedule a follow-up appointment within 1-2 weeks.
• Remove sutures if non-dissolvable ones were used.
• Discuss pathology results if a biopsy was performed.
• Monitor for any signs of complications.

Alternative Treatments

There are non-surgical options available.

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

Home Care Tips

Simple home care can aid in recovery.

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

Patient Education & Prevention

Education is key to preventing future lesions.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect against UV damage.
• Avoid tanning beds and excessive sun exposure.
• Report any changes in existing skin lesions promptly.

Billing and Coding Information

CPT Code: 21725

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 excision of benign lesions.
• 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.
• 11406 - 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.

References and Sources

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