Title: Review of the Integumentary Excision of Lesion Codes (11400-11646)
Body: Coding Communication
CPT guidelines for excision of benign lesions state: "Excision (including simple closure) of benign lesions of skin or subcutaneous tissues (eg, cicatricial, fibrous, inflammatory, congenital, cystic lesions), including local anesthesia. is defined as full-thickness (through the dermis) removal of the following lesions and includes simple (nonlayered) closure. The closure of defects created by incision, excision, or trauma may require intermediate (layered) closure. Layered closure involves dermal closure with separate suture closure of at least one of the deeper layers of subcutaneous and nonmuscle fascial tissues.
The excision of benign lesions codes (11400-11446) are used to report the excision of a scar. In the guidelines for the use of these codes, cicatricial lesions are listed as examples of benign lesions. means "pertaining to or resembling a scar." A hypertrophic scar is an example of a cicatricial lesion. These codes include simple closure of the wound created by the scar removal. When tissue transfer or rearrangement are used to reverse a scar, see codes 14000-14350.
A physician excises a 1 cm hypertrophic scar of the forearm and the defect is closed with a simple repair. The appropriate code to report in this case would be 11401. If the excision of lesion involves an intermediate closure, then the appropriate intermediate repair code (12031-12057) should be reported separately in addition to the excision of lesion code.
A physician excises a 2 cm benign lesion from the face and performs a 4 cm layered closure. In this case, CPT code 11442 should be reported for the excision of the benign lesion, in addition to code 12052 for the intermediate repair of the resulting defect. Often, a defect is created when revising a scar. Scar revision requiring complex closure would be reported using a repair code, selected by the type of repair performed and the extent of the scarring.
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