How To Use CPT Code 11420

CPT 11420 refers to the excision of a benign lesion, excluding skin tags, on specific body areas with a diameter of 0.5 cm or less. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11420.

1. What is CPT 11420?

CPT 11420 is a medical procedure code used to describe the excision of a benign lesion, excluding skin tags, on specific body areas such as the scalp, neck, hands, feet, and genitalia. The excised lesion should have a diameter of 0.5 cm or less, including margins. This code is used by medical professionals to accurately document and bill for this specific procedure.

2. 11420 CPT code description

The official description of CPT code 11420 is: “Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less.”

3. Procedure

The 11420 procedure involves the following steps:

1. The patient is appropriately prepped, and the area is anesthetized.
2. The provider holds a scalpel or other bladed instrument perpendicular to the benign lesion, not a skin tag, measuring 0.5 cm or less in diameter, including margins, on the skin of the scalp, neck, hands, feet, or genitals.
3. The provider excises down into the subcutaneous tissue in an elliptical, wedge, or circular shape to remove the entire lesion.
4. The specimen may be submitted to a laboratory for analysis.
5. The provider checks for bleeding and then closes the wound in a single layer.

4. Qualifying circumstances

Patients eligible to receive CPT code 11420 services are those with a benign lesion, excluding skin tags, on the scalp, neck, hands, feet, or genitalia, with a diameter of 0.5 cm or less, including margins. The lesion must be noncancerous and not listed elsewhere in the CPT code system.

5. When to use CPT code 11420

It is appropriate to bill the 11420 CPT code when a medical professional performs the excision of a benign lesion, excluding skin tags, on the specified body areas, with a diameter of 0.5 cm or less, including margins. The code should be used to accurately document and bill for this specific procedure.

6. Documentation requirements

To support a claim for CPT 11420, the following information needs to be documented:

• Patient’s medical history and physical examination findings
• Indication for the procedure, including the size, location, and type of lesion
• Description of the procedure, including anesthesia, excision technique, and wound closure
• Postoperative care instructions and follow-up plan
• Pathology report, if the specimen was submitted for analysis

7. Billing guidelines

When billing for CPT code 11420, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 11420 include:

• Use modifier 59, Distinct procedural service, when multiple lesions of the same or different diameters are excised during the same session.
• Differentiate between codes for shaving and excision by considering the removal’s depth. Excision involves full thickness, or through the dermis, while shaving involves sharp removal without a full-thickness dermal excision.

8. Historical information

CPT 11420 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2003, with the previous descriptor being “Excision, benign lesion, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less.”

9. Similar codes to CPT 11420

Five similar codes to CPT 11420 differentiate from CPT 11420 as follows:

• CPT 11421: The same procedure on a lesion with a diameter of 0.6 to 1.0 cm.
• CPT 11422: The same procedure on a lesion with a diameter of 1.1 to 2.0 cm.
• CPT 11423: The same procedure on a lesion with a diameter of 2.1 to 3.0 cm.
• CPT 11424: The same procedure on a lesion with a diameter of 3.1 to 4.0 cm.
• CPT 11426: The same procedure on a lesion with a diameter of over 4 cm.

10. Examples

Here are 10 detailed examples of CPT code 11420 procedures:

1. Excision of a 0.5 cm benign nevus on the scalp, including margins.
2. Removal of a 0.4 cm benign lesion on the neck, including margins.
3. Excision of a 0.3 cm benign lesion on the hand, including margins.
4. Removal of a 0.5 cm benign lesion on the foot, including margins.
5. Excision of a 0.2 cm benign lesion on the genitalia, including margins.
6. Removal of a 0.5 cm benign nevus on the neck, including margins.
7. Excision of a 0.4 cm benign lesion on the scalp, including margins.
8. Removal of a 0.3 cm benign lesion on the genitalia, including margins.
9. Excision of a 0.5 cm benign lesion on the hand, including margins.
10. Removal of a 0.2 cm benign lesion on the foot, including margins.