2025 CPT code 11442
Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Excision of a benign lesion, including margins, on the face, ears, eyelids, nose, lips, or mucous membrane; excised diameter 1.1 to 2.0 cm.
Modifiers may be applicable. Modifier 51 (Multiple Procedures) may be used if multiple lesions are excised. Anatomical modifiers may be necessary to specify the location of multiple lesions. Modifier 22 (Increased Procedural Services) may be used if the procedure is significantly more complex than usual.
Medical necessity for excision of benign lesions must be documented. Reasons may include pain, bleeding, interference with function, or suspicion of malignancy. Cosmetic reasons are typically not covered by insurance.
The physician marks the lesion, cleanses the area, and administers local anesthesia. They then excise the lesion down to the subcutaneous tissue, ensuring adequate margins for complete removal. The excised tissue is sent for examination. Bleeding is controlled, and the wound is closed with a simple suture.
In simple words: Removal of a non-cancerous skin growth on the face, ears, eyelids, nose, lips, or inside the mouth. The area removed, including a safety margin of healthy skin, is between 1.1 and 2.0 centimeters.
The physician excises a benign (noncancerous) lesion, including margins, from the face, ears, eyelids, nose, lips, or mucous membrane. The excised diameter is 1.1 to 2.0 cm. This includes simple (non-layered) closure. The code selection is based on the greatest clinical diameter of the apparent lesion plus the margin required for complete excision. The margin is the narrowest margin required for adequate excision, based on clinical judgment. The measurement of the lesion plus margin is made before the excision.
Example 1: A patient presents with a 1.5 cm benign nevus on their cheek. The physician excises the lesion, including margins, and closes the wound with a simple suture. The excised diameter is 1.8 cm, so CPT code 11442 is reported., A patient has a 1.2 cm cyst on their eyelid. The physician excises the cyst, including margins, and closes the defect with a simple closure. The excised diameter is 1.4 cm, and CPT code 11442 is appropriate., A patient has a 1.8 cm benign dermatofibroma on their nose. The physician removes the lesion, including margins, and performs a simple closure. The excised diameter is 1.9 cm, and CPT code 11442 is reported.
Documentation should include the location and size of the lesion, the size of the margins taken, the method of excision, the type of closure, and the diagnosis. Photographs of the lesion before and after excision can be helpful.
- Global Days: 0
- Specialties:Dermatology, Plastic Surgery, General Surgery, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center