Overview of CPT Code 23358: Excision of skin lesion, malignant

Overview of CPT Code 23358: Excision of skin lesion, malignant

CPT Code 23358 refers to the surgical excision of a malignant skin lesion. This procedure is performed to remove cancerous skin growths, ensuring complete removal to prevent further spread of cancer.

When CPT Code 23358 is Used?

This code is applicable in various clinical scenarios.

• Presence of a malignant skin lesion confirmed by biopsy.
• Lesions that are symptomatic, such as causing pain or discomfort.
• Lesions that are growing or changing in appearance.
• Lesions located in areas where they may cause functional impairment.

Symptoms Indicating This Procedure

Patients may report several symptoms that warrant this procedure.

• A new growth on the skin that appears irregular.
• Changes in an existing mole, such as color or size.
• Itching, bleeding, or oozing from the lesion.
• Pain or discomfort in the area of the lesion.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention.

• Excessive sun exposure leading to skin damage.
• Family history of skin cancer.
• Weakened immune system due to conditions or medications.
• Previous history of skin cancer or atypical moles.

Diagnostic Tests Before Procedure

Several tests may be conducted to confirm the diagnosis.

• Skin biopsy to confirm malignancy.
• Imaging studies if the lesion is suspected to have spread.
• Dermatoscopy for detailed examination 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

Proper preparation is essential for a smooth procedure.

• Avoid blood thinners and certain medications as advised by the doctor.
• Do not apply any creams or lotions on the lesion before the procedure.
• Arrive at the facility with a responsible adult if sedation is used.

Recovery and Aftercare

Recovery varies by individual but generally follows a standard process.

• Keep the surgical site clean and dry.
• Change dressings as instructed by the healthcare provider.
• Monitor for signs of infection such as increased redness or discharge.
• Follow up for suture removal as directed.

Possible Complications

While complications are rare, they can occur.

• Infection at the surgical site.
• Scarring or changes in skin pigmentation.
• Recurrence of the lesion if not completely excised.
• Allergic reactions to anesthesia.

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Post-Procedure Follow-Up

Follow-up is crucial for monitoring recovery.

• Schedule a follow-up appointment within 1-2 weeks post-surgery.
• Regular skin checks for new lesions or changes.
• Discuss pathology results and further treatment if necessary.

Alternative Treatments

There are non-surgical options available for some patients.

• Topical chemotherapy for superficial skin cancers.
• Cryotherapy to freeze off precancerous lesions.
• Photodynamic therapy for certain types of skin cancer.

Home Care Tips

Simple home care can aid in recovery.

• Keep the area clean and avoid touching it unnecessarily.
• Use over-the-counter pain relief as needed.
• Stay hydrated and maintain a balanced diet to support healing.

Patient Education & Prevention

Education is key to preventing skin cancer.

• Regularly check your skin for new or changing lesions.
• Use sunscreen with a high SPF to protect against UV rays.
• Avoid tanning beds and excessive sun exposure.

Billing and Coding Information

CPT Code: 23358

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 $500 to $3,000 depending on complexity.
• Most insurance plans cover excision of malignant 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.
• 11600 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 11601 - Excision, malignant skin lesion, face, ears, scalp, neck; excised diameter over 4.0 cm.
• 17301 - Excision of skin lesion, malignant