How To Use CPT Code 11423
CPT 11423 refers to the excision of a benign lesion, excluding skin tags, on specific body areas with a diameter of 2.1 to 3.0 cm. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11423.
1. What is CPT 11423?
CPT 11423 is a medical billing 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 2.1 to 3.0 cm, including margins. This code is used by medical professionals to accurately document and bill for this specific procedure.
2. 11423 CPT code description
The official description of CPT code 11423 is: “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 11423 procedure involves the following steps:
- The patient is appropriately prepped, and the area is anesthetized.
- The provider holds a scalpel or other bladed instrument perpendicular to the benign lesion, not a skin tag, measuring 2.1 to 3.0 cm in diameter, including margins, on the skin of the scalp, neck, hands, feet, or genitals.
- The provider excises the lesion down into the subcutaneous tissue in an elliptical, wedge, or circular shape to remove the entire lesion.
- The excised specimen may be submitted to a laboratory for analysis.
- The provider checks for bleeding and then closes the wound in a single layer.
4. Qualifying circumstances
Patients eligible to receive CPT code 11423 services are those with a benign lesion, excluding skin tags, on the scalp, neck, hands, feet, or genitalia, with a diameter of 2.1 to 3.0 cm, including margins. The lesion must be noncancerous and not listed elsewhere in the CPT code system. The provider must determine that excision is the appropriate treatment for the lesion.
5. When to use CPT code 11423
It is appropriate to bill the 11423 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 2.1 to 3.0 cm, 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 11423, the following information should be documented:
- Patient’s medical history and physical examination findings
- Location, size, and type of the lesion
- Preoperative diagnosis and indication for the procedure
- Details of the anesthesia used
- Step-by-step description of the procedure performed
- Postoperative diagnosis and any complications encountered
- Pathology report, if the specimen was submitted for analysis
- Follow-up care instructions and plan
7. Billing guidelines
When billing for CPT code 11423, it is essential to follow the appropriate guidelines and rules. If multiple lesions of the same or different diameters are excised during the same session, apply modifier 59, Distinct procedural service, to the code(s) for the additional lesion(s). To differentiate between codes for shaving and excision, consider 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 11423 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 2.1 to 3.0 cm.”
9. Similar codes to CPT 11423
Five similar codes to CPT 11423 differentiate as follows:
- CPT 11420: Excision of a benign lesion with a diameter of 0.5 cm or less
- CPT 11421: Excision of a benign lesion with a diameter of 0.6 to 1.0 cm
- CPT 11422: Excision of a benign lesion with a diameter of 1.1 to 2.0 cm
- CPT 11424: Excision of a benign lesion with a diameter of 3.1 to 4.0 cm
- CPT 11426: Excision of a benign lesion with a diameter of over 4 cm
Here are 10 detailed examples of CPT code 11423 procedures:
- Excision of a 2.5 cm seborrheic keratosis on the neck
- Removal of a 3.0 cm lipoma on the scalp
- Excision of a 2.1 cm epidermoid cyst on the hand
- Removal of a 2.8 cm pyogenic granuloma on the foot
- Excision of a 2.3 cm dermatofibroma on the genitalia
- Removal of a 2.9 cm pilomatricoma on the neck
- Excision of a 2.2 cm hidradenoma on the hand
- Removal of a 2.7 cm angiokeratoma on the foot
- Excision of a 2.4 cm trichilemmal cyst on the scalp
- Removal of a 2.6 cm neurofibroma on the genitalia