CPT® Code 11423

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm

The procedure described by CPT® Code 11423 involves the excision of a benign lesion, which is defined as a non-cancerous growth that can occur on various parts of the body, specifically the scalp, neck, hands, feet, or genitalia. This excision is performed with the inclusion of margins, which refers to the surrounding healthy tissue that is also removed to ensure complete excision of the lesion and to minimize the risk of recurrence. It is important to note that skin tags are excluded from this procedure unless they are specifically listed elsewhere in the coding guidelines. Common types of benign lesions that may be excised using this code include lipomas (fatty tumors), dermatofibromas (fibrous skin nodules), pyogenic granulomas (small, red, and raised lesions), epidermoid cysts (small lumps beneath the skin), and benign nevi (moles). During the procedure, the area surrounding the lesion is first cleansed to reduce the risk of infection, followed by the administration of a local anesthetic to ensure patient comfort. A careful identification of a narrow margin of healthy tissue surrounding the lesion is crucial, as this margin is necessary for effective excision. A full-thickness incision is then made through the dermis, which is the thick layer of skin beneath the epidermis. The incision is made in a circular manner around the lesion, allowing for the complete removal of the lesion along with the surrounding healthy tissue. After excision, the specimen is typically sent to a laboratory for histologic evaluation, which is a separate reportable service that assesses the tissue for any signs of malignancy or other abnormalities. To manage any bleeding that may occur during the procedure, electrocautery or chemical cautery techniques are employed. Once the lesion is excised, the surgical wound may be closed using a simple single-layer suture technique. However, depending on the complexity of the wound, other closure methods such as intermediate (layer) closure, complex repair, skin grafts, or pedicle flaps may also be utilized. This code specifically applies to lesions with an excised diameter ranging from 2.1 to 3.0 cm, and it is essential to select the appropriate code based on the size of the lesion excised, with other codes available for different excision diameters.