How To Use CPT Code 11441

CPT 11441 refers to the excision of a benign lesion including margins on the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.6 to 1.0 cm. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11441 procedures.

1. What is CPT 11441?

CPT 11441 is a medical procedure code used to describe the excision of a benign lesion including margins on the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.6 to 1.0 cm. This code is used by medical coders and billers to accurately document and bill for this specific procedure.

2. 11441 CPT code description

The official description of CPT code 11441 is: “Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm.”

3. Procedure

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. 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 provider cuts out the lesion 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 provider closes the wound in a single layer.

4. Qualifying circumstances

Patients eligible to receive CPT code 11441 services are those with a benign lesion on the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.6 to 1.0 cm. The lesion must be noncancerous and not a skin tag. The procedure must be medically necessary, as removal of benign skin lesions that do not pose a threat to health or function is considered cosmetic and not covered by the Medicare program.

5. When to use CPT code 11441

It is appropriate to bill the 11441 CPT code when a provider excises a benign lesion including margins on the face, ears, eyelids, nose, lips, or mucous membrane with a diameter of 0.6 to 1.0 cm. The procedure must be medically necessary and not considered cosmetic.

6. Documentation requirements

To support a claim for CPT 11441, the following information needs to be documented:

• Medical necessity for the procedure
• Location of the lesion
• Size of the lesion (diameter)
• Details of the procedure performed
• Pathology report for the excised lesion

7. Billing guidelines

When billing for CPT code 11441, follow these guidelines and rules:

• Ensure the procedure is medically necessary and not considered cosmetic.
• Apply modifier 59, Distinct procedural service, to the code(s) for additional lesion(s) if multiple lesions of the same or different diameters are excised during the same session.
• Report anatomic modifiers to identify the location of the lesions.
• Differentiate between codes for shaving and excision by looking at the removal’s depth and margins.

8. Historical information

CPT 11441 was added to the Current Procedural Terminology system on January 1, 1990. There have been updates to the code description since then:

• Code Changed on 01-01-2003: Excision, other benign lesion (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
• Code Changed on 01-01-2006: Excision, other benign lesion including margins (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm

9. Similar codes to CPT 11441

Five similar codes to CPT 11441 differentiate based on the diameter of the lesion excised:

• For a lesion with a diameter of 0.5 cm or less, see CPT 11440.
• For a lesion with a diameter of 1.1 to 2.0 cm, see CPT 11442.
• For a lesion with a diameter of 2.1 to 3.0 cm, see CPT 11443.
• For a lesion with a diameter of 3.1 to 4.0 cm, see CPT 11444.
• For a lesion with a diameter of over 4 cm, see CPT 11446.

10. Examples

Here are 10 detailed examples of CPT code 11441 procedures:

1. Excision of a 0.8 cm benign lesion on the patient’s left cheek including margins and simple closure.
2. Excision of a 1.0 cm benign lesion on the patient’s right eyelid including margins and simple closure.
3. Excision of a 0.7 cm benign lesion on the patient’s nose including margins and simple closure.
4. Excision of a 0.9 cm benign lesion on the patient’s left ear including margins and simple closure.
5. Excision of a 0.6 cm benign lesion on the patient’s upper lip including margins and simple closure.
6. Excision of a 0.8 cm benign lesion on the patient’s right cheek including margins and simple closure, followed by excision of a 1.2 cm benign lesion on the patient’s left cheek (CPT 11442 with modifier 59).
7. Excision of a 0.9 cm benign lesion on the patient’s chin including margins and simple closure.
8. Excision of a 1.0 cm benign lesion on the patient’s forehead including margins and simple closure.
9. Excision of a 0.7 cm benign lesion on the patient’s left nostril including margins and simple closure.
10. Excision of a 0.6 cm benign lesion on the patient’s right earlobe including margins and simple closure.