Overview of CPT Code 21805: Excision of benign skin lesion, face, ears, scalp

Overview of CPT Code 21805: Excision of benign skin lesion, face, ears, scalp

CPT Code 21805 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 21805 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 and early detection.

• 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 proceeding with the excision, certain diagnostic tests may be conducted.

• Physical examination of the lesion.
• Dermatoscopy to assess the characteristics of the lesion.
• Biopsy if there is any suspicion of malignancy.

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.
• Post-operative care instructions are provided.

Preparation for the Procedure

Proper preparation can enhance the success of the procedure.

• Avoid blood thinners and certain medications as advised by the physician.
• Arrive at the appointment with clean skin, free of makeup or lotions.
• Discuss any allergies or medical conditions with the healthcare provider.

Recovery and Aftercare

Post-procedure care is crucial for optimal healing.

• Keep the area clean and dry for the first few days.
• Change dressings as instructed by the healthcare provider.
• Avoid sun exposure on the healing site.
• Take prescribed pain medications as needed.

Possible Complications

While complications are rare, they can occur.

• Infection at the site of excision.
• Scarring or changes in skin pigmentation.
• Delayed healing of the wound.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up appointments are important for monitoring recovery.

• Schedule a follow-up visit within 1-2 weeks to assess healing.
• Monitor for any signs of infection or complications.
• Discuss pathology results if a biopsy was performed.

Alternative Treatments

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

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

Home Care Tips

Simple home care can aid in recovery.

• Keep the excision site clean and dry.
• Avoid picking at scabs or the wound.
• Use sunscreen on the area once healed to prevent discoloration.

Patient Education & Prevention

Educating patients can help prevent future lesions.

• Regular skin checks for new or changing lesions.
• Use of sunscreen to protect skin from UV damage.
• Avoiding tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 21805

Category: Surgical Procedures

Common Modifiers:

• 50 (bilateral procedure)
• RT (right side)
• LT (left side)

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

• 21800 - Incision and Drainage of Breast Abscess

References and Sources

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