Overview of CPT Code 21931: Excision of benign skin lesion

Overview of CPT Code 21931: Excision of benign skin lesion

CPT Code 21931 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 21931 is Used?

This code is applicable in various clinical scenarios.

• Removal of a benign skin tumor that is symptomatic or causing discomfort.
• Excision of a lesion for cosmetic reasons.
• Lesions that have changed in appearance and require evaluation.
• Skin lesions that are suspected to be precursors to skin cancer.

Symptoms Indicating This Procedure

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

• Itching or irritation at the site of the lesion.
• Bleeding or oozing from the lesion.
• Changes in the size, shape, or color of 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.
• Previous skin injuries or infections.
• Certain skin conditions like seborrheic keratosis or dermatofibromas.

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.
• Dressing is applied to protect the area.

Preparation for the Procedure

Proper preparation can enhance the success of the procedure.

• Avoid blood thinners like aspirin a week before the procedure.
• Discuss any allergies with your healthcare provider.
• Arrive with clean skin, free of lotions or creams.
• Have a responsible adult accompany you for post-procedure care.

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 your 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 pigmentation.
• Recurrence of the lesion.
• 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 not dissolvable during the follow-up.
• Monitor for any unusual changes in the excised area.

Alternative Treatments

There are non-surgical options available.

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

Home Care Tips

Simple tips 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 can help prevent future lesions.

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

Billing and Coding Information

CPT Code: 21931

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