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2025 CPT code 11622

Excision of malignant skin lesion (1.1-2.0 cm diameter), including margins, from scalp, neck, hands, feet, or genitalia.

Adhere to current CPT guidelines for excision of malignant lesions, particularly regarding measurement of lesion diameter, margins, and the classification of wound closure. Pay attention to payer-specific guidelines.

Modifiers 58 (staged or related procedure), 59 (distinct procedural service), and 22 (increased procedural service) may be applicable under specific circumstances.Consult CPT guidelines for appropriate usage.

The medical necessity for excision of a malignant lesion is established by a confirmed diagnosis of cancer through biopsy or other diagnostic methods.The size, location, and potential for metastasis influence the need for immediate surgical intervention.

The physician is responsible for pre-operative assessment, obtaining informed consent, performing the excision with appropriate local anesthesia, ensuring complete removal of the lesion, hemostasis, and simple wound closure.The physician may also order and interpret pathology results.Post-operative care may be handled by the physician or other qualified healthcare professionals. This will require separate billing and depends on payer-specific rules.

IMPORTANT:For lesions 0.5 cm or less, use 11620. For lesions 0.6-1.0 cm, use 11621. For lesions 2.1-3.0 cm, use 11623. For lesions 3.1-4.0 cm, use 11624. For lesions >4.0 cm, use 11626.If multiple lesions of differing diameters are excised, use modifier 59 for the second lesion. If re-excision is necessary during the postoperative period due to positive margins, use modifier 58.For lesions requiring more than simple closure, use 11600-11646 with appropriate intermediate (12031-12057) or complex closure (13100-13153) codes. For reconstructive closure, use 15002-15261, 15570-15770.Excision is not separately reportable with adjacent tissue transfer (14000-14302).

In simple words: The doctor removes a cancerous skin growth (1.1 to 2 centimeters wide) and a small area of healthy skin around it, from the scalp, neck, hands, feet, or genitals.The area is then stitched closed. The growth is sent to a lab to be checked.

This CPT code describes the surgical removal of a malignant skin lesion, encompassing the lesion and surrounding margins, measuring between 1.1 and 2.0 centimeters in greatest diameter. The procedure includes local anesthesia, full-thickness excision through the dermis, and simple closure of the resulting wound.The excised tissue is typically sent for pathological examination. If frozen section analysis reveals inadequate margins, additional excision may be necessary at the same operative session (coded using only the final excised diameter), or at a subsequent session (using codes 11600-11646 with modifier 58).

Example 1: A 65-year-old male presents with a 1.5 cm basal cell carcinoma on his left cheek. The physician excises the lesion with a 3mm margin, performs a simple closure, and sends the specimen to pathology., A 40-year-old female presents with a 1.8 cm suspicious lesion on her right hand.A frozen section is performed intraoperatively, revealing positive margins.The physician excises an additional margin, resulting in a final excised diameter of 2.2cm.The final lesion is sent for pathology., A 72-year-old patient with a history of melanoma presents with a 1.2 cm lesion on their scalp.The excision is performed, and the wound is closed primarily.The pathology results are positive for melanoma, necessitating a subsequent excision to widen the margins during the postoperative period.

** This code only includes simple closure.Intermediate or complex closure should be billed separately.Always refer to the most recent CPT codebook and payer-specific guidelines for the most up-to-date information and reimbursement policies.

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