2025 CPT code 11624
Effective Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Excision of a malignant lesion, including margins, from the scalp, neck, hands, feet, or genitalia, with an excised diameter of 3.1 to 4.0 cm.
Modifiers may be applicable.For example, modifier 59 may be used for distinct procedural services, and modifier 58 may be used for staged or related procedures during the postoperative period.
Medical necessity is based on the diagnosis of a malignant skin lesion requiring surgical excision.Documentation should support the need for excision based on the lesion's characteristics, size, location, and potential risk to the patient.
The physician prepares the area, administers local anesthesia, marks the margins for excision, excises the lesion with the marked margins, controls bleeding, and closes the wound using simple closure techniques.They may also send the excised tissue for pathological examination.If necessary based on frozen section results, they might perform additional excisions to achieve clear margins.
In simple words: Removal of skin cancer, along with a safety margin of healthy skin, from the head, neck, hands, feet, or genitals. The area removed, including the cancer and the safety margin, is between 3.1 and 4 centimeters.
Excision of a malignant lesion, including margins, from the scalp, neck, hands, feet, or genitalia. The excised diameter, which includes the lesion and the necessary margins for complete excision, ranges from 3.1 to 4.0 cm. This procedure involves full-thickness removal of the lesion and includes simple closure.
Example 1: A patient presents with a 3.5 cm squamous cell carcinoma on the scalp. The physician excises the lesion with appropriate margins, resulting in a total excised diameter of 3.8 cm., A 3.2 cm melanoma is identified on a patient's hand.The physician excises the lesion, including margins, resulting in a 3.9 cm excised diameter., A patient with a 2.9 cm basal cell carcinoma on the neck undergoes excision. Due to the aggressive nature of the lesion, the physician takes wider margins, achieving a final excised diameter of 3.3 cm.
Documentation should include lesion size and location, margins taken, excised diameter, method of closure, and pathology report. Preoperative evaluation and medical necessity should also be clearly documented.
** This code represents the excision of the lesion only and includes simple closure. Complex repairs or reconstructions should be reported separately.Refer to NCCI edits for correct code pairings and modifier usage.Always consult the most recent CPT manual and coding guidelines.
- Specialties:Dermatology, Surgical Oncology, Plastic Surgery, Otolaryngology (for lesions in the head and neck), General Surgery.
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center.