How To Use cpt 11471

cpt 11471 describes the excision of skin and subcutaneous tissue for hidradenitis in the perianal, perineal, or umbilical regions, along with complex repair. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11471.

1. What is cpt 11471?

cpt 11471 is a code used to describe the excision of skin and subcutaneous tissue for the treatment of hidradenitis in the perianal, perineal, or umbilical regions. This procedure involves the removal of the affected skin and subcutaneous tissue, followed by a complex repair to close the excision site. It is important to note that if a skin graft or flap is used for closure, an appropriate procedure code should be used in addition to cpt 11471. Additionally, if the procedure is performed bilaterally, the modifier 50 should be added.

2. Official Description

The official description of cpt 11471 is: ‘Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical with complex repair.’

3. Procedure

In this procedure, the healthcare provider removes the affected skin and subcutaneous tissue in the perianal, perineal, or umbilical regions to treat hidradenitis. The patient is taken to the operating room and placed on the surgical table. The area to be excised is labeled and cleansed. The provider then makes an incision in the vascular inner layer of the skin, dissecting down to and underneath the apocrine (sweat) glands to the level of the diseased tissue. The entire diseased skin and subcutaneous fatty tissues overlying and underneath the apocrine glands are excised, down to the muscular fascia. The provider then performs a complex, layered repair of the wound using heavy reinforcing sutures. In some cases, a graft or flap may be needed for closure of the surgical wound.

4. Qualifying circumstances

cpt 11471 is used for patients with hidradenitis in the perianal, perineal, or umbilical regions. Hidradenitis is a chronic skin condition involving the apocrine sweat glands, typically occurring in areas where rubbing of the skin and excessive sweating occurs. The procedure is performed by a healthcare provider to remove the affected skin and subcutaneous tissue and provide relief to the patient. It is important to note that if a skin graft or flap is used for closure, an appropriate procedure code should be used in addition to cpt 11471. Additionally, if the procedure is performed bilaterally, the modifier 50 should be added.

5. When to use cpt code 11471

cpt 11471 should be used when a healthcare provider performs the excision of skin and subcutaneous tissue for hidradenitis in the perianal, perineal, or umbilical regions, along with complex repair. It is important to use this code when the procedure meets the specific criteria outlined in the official description. If the procedure does not meet these criteria, a different code should be used.

6. Documentation requirements

To support a claim for cpt 11471, the healthcare provider must document the following information:

• Patient’s diagnosis of hidradenitis
• Specific location of the excision (perianal, perineal, or umbilical)
• Details of the excision procedure, including the size and depth of the excised tissue
• Description of the complex repair techniques used
• Any additional procedures performed, such as the use of a skin graft or flap for closure
• Date and duration of the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 11471, ensure that the procedure meets the specific criteria outlined in the official description. It is important to accurately document the details of the excision and complex repair techniques used. If a skin graft or flap is used for closure, an appropriate procedure code should be used in addition to cpt 11471. Additionally, if the procedure is performed bilaterally, the modifier 50 should be added. It is important to follow the specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

cpt 11471 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to cpt 11471

Five similar codes to cpt 11471 include:

• cpt 11470: This code is used for the excision of skin and subcutaneous tissue for hidradenitis in the perianal, perineal, or umbilical regions, with simple or intermediate repair.
• cpt 11472: This code is used for the excision of skin and subcutaneous tissue for hidradenitis in areas other than the perianal, perineal, or umbilical regions, with complex repair.
• cpt 11473: This code is used for the excision of skin and subcutaneous tissue for hidradenitis in areas other than the perianal, perineal, or umbilical regions, with intermediate repair.
• cpt 11474: This code is used for the excision of skin and subcutaneous tissue for hidradenitis in areas other than the perianal, perineal, or umbilical regions, with simple repair.
• cpt 11475: This code is used for the excision of skin and subcutaneous tissue for hidradenitis in areas other than the perianal, perineal, or umbilical regions, without repair.

9. Examples

1. A healthcare provider performs the excision of skin and subcutaneous tissue for hidradenitis in the perianal region, followed by a complex repair.
2. A patient undergoes the excision of skin and subcutaneous tissue for hidradenitis in the perineal region, with the use of a skin graft for closure.
3. A healthcare provider performs the excision of skin and subcutaneous tissue for hidradenitis in the umbilical region, followed by a complex repair involving multiple layers of sutures.