Overview of CPT Code 22145: Excision of soft tissue tumor, deep, greater than 4 cm

Overview of CPT Code 22145: Excision of soft tissue tumor, deep, greater than 4 cm

CPT Code 22145 refers to the surgical excision of a deep soft tissue tumor that measures greater than 4 cm in size. This procedure is typically performed to remove tumors that may be benign or malignant, ensuring complete removal to prevent recurrence and to facilitate further pathological examination.

When CPT Code 22145 is Used?

This code is applicable in various clinical scenarios, including:

• Presence of a deep soft tissue tumor greater than 4 cm.
• Suspicion of malignancy based on imaging or clinical findings.
• Tumors causing pain, discomfort, or functional impairment.
• Need for definitive diagnosis through histopathological examination.

Symptoms Indicating This Procedure

Patients may report the following symptoms that could indicate the need for this procedure:

• A noticeable mass or lump under the skin.
• Pain or tenderness in the area of the tumor.
• Changes in skin color or texture over the tumor.
• Limited range of motion or function in the affected area.

Causes and Risk Factors

Several factors may contribute to the development of deep soft tissue tumors:

• Genetic predisposition to certain types of tumors.
• Previous radiation therapy in the area.
• Chronic inflammation or irritation.
• Certain hereditary syndromes, such as Li-Fraumeni syndrome.

Diagnostic Tests Before Procedure

Before proceeding with the excision, the following diagnostic tests may be conducted:

• Ultrasound imaging to assess the size and depth of the tumor.
• MRI or CT scans for detailed visualization of the tumor and surrounding tissues.
• Biopsy to determine the nature of the tumor (benign vs malignant).
• Blood tests to evaluate overall health and any underlying conditions.

Procedure Description

The excision procedure typically follows these steps:

• Patient is positioned comfortably and anesthesia is administered.
• An incision is made over the tumor site, ensuring adequate margins.
• The tumor is carefully dissected from surrounding tissues.
• Hemostasis is achieved, and the tumor is removed.
• The incision is closed with sutures or staples, and a sterile dressing is applied.

Preparation for the Procedure

Patients should follow these guidelines before the procedure:

• Avoid eating or drinking for at least 8 hours prior to surgery.
• Discuss any medications with the healthcare provider, especially blood thinners.
• Arrange for transportation to and from the procedure.
• Wear loose, comfortable clothing on the day of the surgery.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Resting for the first 24 hours after surgery.
• Keeping the surgical site clean and dry.
• Monitoring for signs of infection, such as increased redness or discharge.
• Taking prescribed pain medications as needed.
• Follow-up appointment to assess healing and remove sutures if necessary.

Possible Complications

While generally safe, this procedure carries some risks, including:

• Infection at the surgical site.
• Excessive bleeding or hematoma formation.
• Scarring or changes in skin sensation.
• Recurrence of the tumor if not completely excised.

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Post-Procedure Follow-Up

Follow-up care is essential for monitoring recovery:

• Initial follow-up within 1-2 weeks to check the surgical site.
• Additional visits may be scheduled based on pathology results.
• Long-term monitoring for recurrence, especially if the tumor was malignant.

Alternative Treatments

In some cases, alternative management options may include:

• Observation for benign tumors without symptoms.
• Radiation therapy for inoperable tumors.
• Chemotherapy for malignant tumors, depending on type and stage.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the surgical area clean and dry.
• Avoid strenuous activities for at least a week.
• Apply ice packs to reduce swelling if needed.
• Follow all post-operative instructions provided by the healthcare team.

Patient Education & Prevention

To reduce the risk of recurrence, patients should consider:

• Regular skin checks for new or changing lesions.
• Healthy lifestyle choices, including diet and exercise.
• Avoiding known risk factors, such as excessive sun exposure.
• Staying informed about family history of tumors.

Billing and Coding Information

CPT Code: 22145

Category: Surgery

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

The cost of this procedure can vary widely:

• Average cost ranges from $2,000 to $5,000 depending on location and complexity.
• Most insurance plans cover this procedure if deemed medically necessary.
• Patients should verify coverage details with their insurance provider.

Related CPT Codes

• 19120 - Excision of Breast Lesion
• 19125 - Excision of breast lesion
• 11406 - Excision, benign skin lesion; face, ears, scalp, neck, excised diameter over 4.0 cm