Overview of CPT Code 23130: Excision of benign lesion, shoulder

Overview of CPT Code 23130: Excision of benign lesion, shoulder

CPT Code 23130 refers to the surgical excision of a benign lesion located on the shoulder. This procedure is typically performed to remove non-cancerous growths that may cause discomfort, cosmetic concerns, or functional impairment.

When CPT Code 23130 is Used?

This code is applicable in various clinical scenarios, including:

• Presence of a benign tumor or cyst on the shoulder.
• Lesions causing pain or discomfort.
• Cosmetic concerns regarding the appearance of the shoulder.
• Lesions that are growing or changing in appearance.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to the consideration of this procedure, including:

• Visible lump or bump on the shoulder.
• Pain or tenderness in the area of the lesion.
• Restricted range of motion due to the lesion.
• Itching or irritation around the lesion.

Causes and Risk Factors

Several factors can contribute to the development of benign lesions on the shoulder.

• Genetic predisposition to skin growths.
• Previous skin injuries or trauma.
• Chronic skin conditions such as eczema.
• Age-related changes in skin and tissue.

Diagnostic Tests Before Procedure

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

• Physical examination of the lesion.
• Ultrasound imaging to assess the lesion's characteristics.
• Biopsy to confirm the benign nature of the lesion.

Procedure Description

The excision procedure typically follows these steps:

• Patient is positioned comfortably, and the shoulder area is cleaned.
• Local anesthesia is administered to numb the area.
• A surgical incision is made 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 wound.

Preparation for the Procedure

Patients should follow these steps to prepare for the excision:

• Consult with the surgeon about any medications being taken.
• Avoid blood thinners and anti-inflammatory medications prior to the procedure.
• Arrive at the facility with clean skin and avoid applying lotions or creams.
• Arrange for transportation home post-procedure if sedation is used.

Recovery and Aftercare

Post-procedure recovery typically involves:

• Resting the shoulder for a few days.
• Keeping the surgical site clean and dry.
• Changing dressings as instructed by the healthcare provider.
• Taking prescribed pain medications as needed.

Possible Complications

While generally safe, there are potential risks associated with the procedure:

• Infection at the surgical site.
• Excessive bleeding during or after the procedure.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion.

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Post-Procedure Follow-Up

Follow-up care is essential for monitoring recovery:

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

Alternative Treatments

In some cases, non-surgical options may be considered:

• Observation for small, asymptomatic lesions.
• Cryotherapy to freeze and reduce the size of the lesion.
• Topical treatments for superficial lesions.

Home Care Tips

Patients can follow these tips for effective home care:

• Keep the incision site clean and dry.
• Avoid strenuous activities that may strain the shoulder.
• Apply ice packs to reduce swelling if needed.
• Follow all post-operative instructions provided by the healthcare team.

Patient Education & Prevention

Educating patients on prevention can help reduce recurrence:

• Regular skin checks for new or changing lesions.
• Sun protection to prevent skin damage.
• Healthy lifestyle choices to support skin health.

Billing and Coding Information

CPT Code: 23130

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• RT - Right side
• LT - Left side

Average Cost and Insurance Coverage

The cost of the procedure can vary based on several factors:

• Average cost ranges from $500 to $2,000 depending on complexity.
• Insurance may cover the procedure if deemed medically necessary.
• Patients should verify coverage with their insurance provider.

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