Overview of CPT Code 23146: Excision of benign skin lesion, face, ears, scalp, neck

Overview of CPT Code 23146: Excision of benign skin lesion, face, ears, scalp, neck

CPT Code 23146 refers to the surgical excision of benign skin lesions located on the face, ears, scalp, or neck. This procedure is typically performed to remove lesions that are non-cancerous but may cause cosmetic concerns or discomfort.

When CPT Code 23146 is Used?

This code is applicable in various clinical scenarios.

• Removal of benign moles or nevi that are cosmetically unappealing.
• 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.
• Lesions that cause discomfort or irritation.
• Cosmetic concerns regarding the appearance of skin lesions.
• Itching or tenderness 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.
• Age-related skin changes resulting in benign growths.
• Previous skin injuries or trauma.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the diagnosis.

• Physical examination of the lesion by a dermatologist.
• Dermatoscopy to assess the characteristics of the lesion.
• Biopsy may be performed 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 excises the lesion along with a margin of healthy tissue.
• The wound is closed with sutures or adhesive strips.
• Post-operative care instructions are provided.

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 medical conditions.
• Arrive with clean skin, free of lotions or makeup.
• Arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure recovery is crucial for healing.

• Keep the surgical site clean and dry.
• 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 involved.

• Infection at the surgical site.
• 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

Non-surgical options may be considered in some cases.

• 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 at home.

• Keep the area clean and avoid touching it.
• Use sunscreen to protect the healing skin.
• Monitor for any changes in the surgical site.

Patient Education & Prevention

Education is key to preventing future lesions.

• Regular skin checks for new or changing lesions.
• Use sunscreen to protect against UV damage.
• Avoid excessive sun exposure, especially during peak hours.

Billing and Coding Information

CPT Code: 23146

Category: Surgical Procedures

Common Modifiers:

• -50
• -RT
• -LT

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.