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2025 CPT code 40500

Vermilionectomy (lip shave) with mucosal advancement.

Refer to the current CPT coding guidelines for surgical procedures.Specific instructions for vermilionectomy are not explicitly detailed in the provided text.

Modifiers 51 (Multiple Procedures), 59 (Distinct Procedural Service), and others may be applicable depending on the specific circumstances of the procedure and other services rendered on the same day.Appropriate modifier usage should always be determined based on the official guidelines and the clinical circumstances.

Medical necessity for vermilionectomy is established by the presence of a lesion (benign or malignant) affecting the vermilion border, requiring removal for cosmetic reasons, or to prevent progression to cancer (in cases like actinic cheilitis).Documentation must support the clinical indication for the procedure.

The provider is responsible for anesthetizing the area, excising the diseased tissue and vermilion border, separating the skin from underlying muscle, and suturing the remaining labial mucosa to the skin to form a new vermilion border.

IMPORTANT:If a wedge resection and lip shave are performed for the same reason, only code 40520. If two procedures are performed for two different lesions, code both 40500 and 40520 with modifier 59 (Distinct procedural service) appended to the code with fewer RVUs.

In simple words: The doctor removes a growth from the edge of the lip where it meets the skin. They numb the area, cut out the growth and any affected lip tissue, carefully stitch the remaining lip skin together to create a new edge.

This procedure involves the surgical removal of a growth from the vermilion border of the lip (where the lip meets the skin).The area is anesthetized, the diseased tissue and vermilion border are excised, the skin is separated from the underlying muscle, and the remaining labial mucosa is sutured to the skin to create a new vermilion border. This is often performed for actinic cheilitis or as a preventative measure for other lesions.It's a non-deforming plastic operation used for prophylaxis and treatment of lip cancer, and cosmetic correction of certain congenital, neoplastic, and traumatic lip deformities.

Example 1: A patient presents with actinic cheilitis (precancerous lip lesions) on the lower lip. The physician performs a vermilionectomy to remove the affected tissue and prevent progression to cancer., A patient has a small benign tumor on the vermilion border of their upper lip.A vermilionectomy is performed for cosmetic improvement and to remove the growth., Following a traumatic lip injury resulting in a significant scar on the vermilion border, the patient undergoes a vermilionectomy with mucosal advancement to restore the lip’s natural appearance.

Detailed operative report including pre-operative diagnosis, description of the excised tissue (size, location, type), type of anesthesia used,method of tissue closure, and post-operative instructions.Pathology report confirming the diagnosis of the excised tissue.Photographs of the lesion before and after the procedure may also be beneficial.

** Always ensure accurate documentation and appropriate modifier usage to ensure proper billing and reimbursement. The decision to use 40500 vs. 40520 depends on the nature of the lesion and the procedure performed.Consult with a qualified medical billing specialist for any questions regarding coding or billing practices.

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