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The CPT® Code 11623 refers to the excision of a malignant lesion located on specific areas of the body, including the scalp, neck, hands, feet, or genitalia. This procedure involves the removal of the malignant tissue along with a margin of healthy tissue to ensure complete excision of the cancerous cells. Common types of malignant lesions that may be excised using this code include basal cell carcinoma, squamous cell carcinoma, verrucous carcinoma, and melanoma. The procedure begins with the cleansing of the affected area, followed by the administration of a local anesthetic to minimize discomfort during the excision. A careful identification of a healthy tissue margin is crucial, as it helps to ensure that all cancerous cells are removed. A full-thickness incision is then made through the dermis, encircling the lesion to facilitate its complete removal. In some cases, a frozen section may be performed during the excision to verify that the margins are clear of malignant cells. If any malignant tissue is detected at the margins, additional tissue will be excised until all margins are confirmed to be clean. The excised lesion is subsequently sent to a laboratory for histologic evaluation, which is also reportable separately. To manage any bleeding that may occur during the procedure, electrocautery or chemical cautery techniques are employed. Finally, the surgical wound may be closed using a simple single-layer suture technique, although more complex closure methods such as intermediate (layer) closure, complex repair, skin grafts, or pedicle flaps may also be utilized depending on the specific circumstances of the excision.
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The procedure associated with CPT® Code 11623 is indicated for the excision of malignant lesions located on the scalp, neck, hands, feet, or genitalia. The specific conditions or symptoms that may warrant this procedure include:
The procedure for excising a malignant lesion as described by CPT® Code 11623 involves several critical steps:
After the excision procedure, patients are typically monitored for any immediate complications, such as excessive bleeding or infection. Instructions for post-procedure care will be provided, which may include keeping the surgical site clean and dry, monitoring for signs of infection, and managing pain with prescribed medications. Follow-up appointments may be scheduled to assess the healing process and to discuss the results of the histologic evaluation. Patients should be advised to avoid strenuous activities that could stress the surgical site during the initial recovery period.
| Short Descr | EXC S/N/H/F/G MAL+MRG 2.1-3 | Medium Descr | EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM | Long Descr | Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5A - Ambulatory procedures - skin | MUE | 2 | CCS Clinical Classification | 170 - Excision of skin lesion |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 73 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | AG | Primary physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CG | Policy criteria applied | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | FA | Left hand, thumb | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | SG | Ambulatory surgical center (asc) facility service | T5 | Right foot, great toe | T6 | Right foot, second digit | T7 | Right foot, third digit | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2017-01-01 | Changed | Medium description changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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