Overview of CPT Code 21920: Excision of benign skin lesion

Overview of CPT Code 21920: Excision of benign skin lesion

CPT Code 21920 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 to become problematic.

When CPT Code 21920 is Used?

This code is applicable in various clinical scenarios.

• Removal of a benign mole that is changing in appearance.
• Excision of a lipoma that is causing pain or discomfort.
• Surgical removal of a seborrheic keratosis that is bothersome to the patient.
• Excision of a dermatofibroma that is symptomatic or for cosmetic reasons.

Symptoms Indicating This Procedure

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

• A lesion that is growing or changing in color.
• Itching or irritation around the lesion.
• Pain or tenderness in the area of the lesion.
• Cosmetic concerns regarding the appearance 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.
• Previous skin injuries or trauma.
• Certain skin conditions that predispose to benign growths.

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 uncertainty about the nature of the lesion.

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

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 creams.
• 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 dressings as instructed by the healthcare provider.
• Avoid strenuous activities for at least a week.
• Take prescribed pain medications as needed.

Possible Complications

While generally safe, there are potential risks.

• Infection at the site of excision.
• Scarring or changes in skin pigmentation.
• Bleeding or hematoma formation.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up is essential to monitor healing.

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

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 incision.
• Use sunscreen on the area once healed.
• Stay hydrated and maintain a healthy diet.

Patient Education & Prevention

Education can help prevent future lesions.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect skin from UV damage.
• Avoid tanning beds and excessive sun exposure.
• Consult a dermatologist for any skin concerns.

Billing and Coding Information

CPT Code: 21920

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 $1,000.
• Insurance may cover the procedure if deemed medically necessary.
• Out-of-pocket costs depend 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.
• 12001 - Simple Repair of Laceration, Face, Ears, Eyelids, Nose
• 12002 - Simple repair of superficial wound, face, ears, eyelids, scalp, neck

References and Sources

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