Overview of CPT Code 21812: Excision of benign skin lesion, face, ears, scalp, neck

Overview of CPT Code 21812: Excision of benign skin lesion, face, ears, scalp, neck

CPT Code 21812 refers to the surgical excision of benign skin lesions located on the face, ears, scalp, or neck. This procedure is typically performed to remove growths that are non-cancerous but may cause cosmetic concerns or discomfort.

When CPT Code 21812 is Used?

This code is applicable in various clinical scenarios.

• Removal of benign moles or nevi that are cosmetically undesirable.
• Excision of seborrheic keratosis that may be irritated or inflamed.
• Surgical intervention for lipomas located on the face or neck.
• Excision of dermatofibromas that are symptomatic or bothersome.

Symptoms Indicating This Procedure

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

• Visible growths on the skin that are changing in size or color.
• Itching or irritation associated with the lesion.
• Bleeding or oozing from the lesion.
• Discomfort or pain in the area 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 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 may be performed if malignancy is suspected.

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.
• A scalpel is used to excise the lesion along with a margin of healthy tissue.
• The wound is closed with sutures or adhesive strips.
• Dressing is applied to protect the area.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Avoid blood thinners such as aspirin or ibuprofen a week prior.
• Inform the doctor of any allergies or medications being taken.
• Arrive with clean skin, free of lotions or makeup.

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 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 sutures or topical medications.

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Post-Procedure Follow-Up

Follow-up is essential to monitor healing.

• Schedule a follow-up appointment within 1-2 weeks.
• Sutures may be removed during this visit if applicable.
• Report any unusual symptoms immediately.

Alternative Treatments

There are non-surgical options available.

• Cryotherapy for superficial lesions.
• Topical treatments for certain benign skin conditions.
• Laser therapy for cosmetic concerns.

Home Care Tips

Simple tips 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

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: 21812

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.
• 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