How To Use CPT Code 11440

CPT 11440 refers to the excision of a benign lesion including margins from the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.5 cm or less. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11440 procedures.

1. What is CPT 11440?

CPT 11440 is a medical procedure code used to describe the excision of a benign lesion including margins from specific areas of the face and mucous membrane. The lesion must have a diameter of 0.5 cm or less for this code to be applicable. This code is used by medical professionals to accurately document and bill for this specific procedure.

2. 11440 CPT code description

The official description of CPT code 11440 is: “Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less.”

3. Procedure

The 11440 procedure involves the following steps:

  1. The patient is taken to the operating room and placed on the surgical table.
  2. The lesion is outlined with a pencil.
  3. The area is washed out with an antiseptic skin solution such as Betadine.
  4. A local anesthetic is applied to make the area insensitive.
  5. The provider incises through the vascular inner layer of skin and carries it down into the level of subcutaneous tissue (fatty layer).
  6. The lesion is cut out in an oval shape with the help of surgical instruments to remove the entire lesion.
  7. The lesion sample is sent to the laboratory for examination.
  8. Blood flow is controlled with electrocautery, taking care not to destroy the tissue framework.
  9. The wound is closed in a single layer.

4. Qualifying circumstances

Patients eligible to receive CPT code 11440 services are those with a benign lesion located on the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.5 cm or less. The lesion must not be a skin tag or listed elsewhere in the CPT code system. The excision must be medically necessary and not considered cosmetic.

5. When to use CPT code 11440

It is appropriate to bill the 11440 CPT code when a provider excises a benign lesion including margins from the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.5 cm or less. The procedure must be medically necessary and not considered cosmetic. If the lesion is larger or smaller than the specified diameter, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 11440, the following information should be documented:

  • Medical necessity for the excision of the lesion
  • Location of the lesion
  • Size of the lesion (diameter)
  • Procedure steps performed
  • Pathology report for the excised lesion

7. Billing guidelines

When billing for CPT code 11440, it is important to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 11440 include:

  • Use modifier 59, Distinct procedural service, when multiple lesions are excised during the same session.
  • Report anatomic modifiers to identify the location of the lesions.
  • Differentiate between codes for shaving and excision based on the removal’s depth and margins.
  • Ensure the clinical documentation supports the medical necessity of the excision.

8. Historical information

CPT 11440 was added to the Current Procedural Terminology system on January 1, 1990. There have been updates to the code description since then, with the most recent change occurring on January 1, 2006.

9. Similar codes to CPT 11440

Five similar codes to CPT 11440 differentiate based on the diameter of the excised lesion:

  • For a diameter of 0.6 to 1.0 cm, see CPT 11441.
  • For a diameter of 1.1 to 2.0 cm, see CPT 11442.
  • For a diameter of 2.1 to 3.0 cm, see CPT 11443.
  • For a diameter of 3.1 to 4.0 cm, see CPT 11444.
  • For a diameter of over 4 cm, see CPT 11446.

10. Examples

Here are 10 detailed examples of CPT code 11440 procedures:

  1. Excision of a 0.5 cm benign lesion on the upper eyelid including margins.
  2. Removal of a 0.4 cm benign lesion on the tip of the nose with margins.
  3. Excision of a 0.3 cm benign lesion on the lower lip including margins.
  4. Removal of a 0.5 cm benign lesion on the left earlobe with margins.
  5. Excision of a 0.2 cm benign lesion on the right cheek including margins.
  6. Removal of a 0.5 cm benign lesion on the forehead with margins.
  7. Excision of a 0.4 cm benign lesion on the chin including margins.
  8. Removal of a 0.3 cm benign lesion on the left nostril with margins.
  9. Excision of a 0.5 cm benign lesion on the right temple including margins.
  10. Removal of a 0.1 cm benign lesion on the upper lip with margins.

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