CPT® Code 41116

The CPT® Code 41116 refers to the excision of a lesion located on the floor of the mouth. This procedure involves the careful removal of abnormal tissue that may be causing concern due to its appearance or potential health implications. The process begins with the administration of a local anesthetic, which is injected around and beneath the lesion to ensure that the patient remains comfortable and pain-free during the procedure. Following the anesthesia, a surgical incision is made through the mucosal layer and the underlying submucosal tissue. This incision is strategically designed to encircle the lesion, allowing for its complete excision. Importantly, the excision is performed not only on the lesion itself but also includes a margin of healthy tissue surrounding it. This practice is crucial as it helps to ensure that any potentially affected cells are removed, thereby reducing the risk of recurrence. After the lesion is excised, it is sent to a laboratory for pathology examination, which is a separate reportable service. This examination is essential for determining the nature of the lesion, whether it is benign or malignant, and guiding any further treatment that may be necessary.