How To Use CPT Code 11602

CPT 11602 refers to the excision of a malignant lesion, including margins, on the trunk, arms, or legs with an excised diameter of 1.1 to 2.0 cm. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11602 procedures.

1. What is CPT 11602?

CPT 11602 is a medical procedure code used to describe the excision of a malignant lesion, including margins, on the trunk, arms, or legs with an excised diameter of 1.1 to 2.0 cm. This code is used by medical coders and billers to accurately document and bill for this specific procedure.

2. 11602 CPT code description

The official description of CPT code 11602 is: “Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm.”

3. Procedure

The 11602 procedure involves the following steps:

1. Preparation of the area and administration of local anesthesia.
2. Identification and outlining of a margin of healthy tissue around the malignant lesion with a marking pen.
3. Full-thickness incision through the skin, excising the entire lesion including the previously outlined margins.
4. Cleaning of all margins and controlling bleeding.
5. Closure of the wound with sutures.
6. Optional: Sending the excised lesion to a laboratory for further evaluation or performing a frozen section to determine if additional excision of margins is needed.

4. Qualifying circumstances

Patients eligible to receive CPT code 11602 services are those with a malignant lesion, such as melanoma, squamous cell carcinoma, or basal cell carcinoma, located on the trunk, arms, or legs, with an excision diameter of 1.1 to 2.0 cm, including the margins. Malignant lesions are locally invasive, can destroy healthy tissue as they grow, and can possibly metastasize (spread from one body part to another).

5. When to use CPT code 11602

It is appropriate to bill the 11602 CPT code when a provider performs an excision of a malignant lesion, including margins, on the trunk, arms, or legs with an excised diameter of 1.1 to 2.0 cm. This code should be used to accurately document and bill for this specific procedure.

6. Documentation requirements

To support a claim for CPT 11602, the following information needs to be documented:

• Patient’s medical history and physical examination findings.
• Diagnosis of the malignant lesion, including type and location.
• Size of the lesion and excised diameter, including margins.
• Details of the procedure, including anesthesia, incision, excision, and closure.
• Any complications or additional procedures performed during the excision.
• Pathology report, if applicable.

7. Billing guidelines

When billing for CPT code 11602, keep in mind the following guidelines and rules:

• If a provider excises multiple lesions of different diameters, apply modifier 59, Distinct procedural service, to the code for the second lesion.
• If the provider performs a second excision on the same lesion area because the pathology report came back with positive margins during the global period of the first excision, append modifier 58 to the second procedure. Modifier 58 should be used when a procedure or service is planned or anticipated at the time of the original procedure (staged) and is more extensive than the original procedure.
• Use the same malignant diagnosis again, even if the most recent excision shows no cancer cells in the specimen.

8. Historical information

CPT 11602 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, malignant lesion, trunk, arms, or legs; lesion diameter 1.1 to 2.0 cm.”

9. Similar codes to CPT 11602

Five similar codes to CPT 11602 differentiate as follows:

• CPT 11600: Excision of a malignant lesion with an excised diameter of 0.5 cm or less.
• CPT 11601: Excision of a malignant lesion with an excised diameter of 0.6 to 1.0 cm.
• CPT 11603: Excision of a malignant lesion with an excised diameter of 2.1 to 3.0 cm.
• CPT 11604: Excision of a malignant lesion with an excised diameter of 3.1 to 4.0 cm.
• CPT 11606: Excision of a malignant lesion with an excised diameter of over 4.0 cm.

10. Examples

Here are 10 detailed examples of CPT code 11602 procedures:

1. Excision of a 1.5 cm diameter melanoma on the patient’s upper arm, including 1 cm margins.
2. Excision of a 1.2 cm diameter squamous cell carcinoma on the patient’s lower leg, including 0.5 cm margins.
3. Excision of a 1.8 cm diameter basal cell carcinoma on the patient’s back, including 0.8 cm margins.
4. Excision of a 1.3 cm diameter melanoma on the patient’s forearm, including 1.5 cm margins.
5. Excision of a 1.9 cm diameter squamous cell carcinoma on the patient’s thigh, including 0.7 cm margins.
6. Excision of a 1.6 cm diameter basal cell carcinoma on the patient’s chest, including 1.2 cm margins.
7. Excision of a 1.1 cm diameter melanoma on the patient’s shoulder, including 0.9 cm margins.
8. Excision of a 1.7 cm diameter squamous cell carcinoma on the patient’s calf, including 1.3 cm margins.
9. Excision of a 1.4 cm diameter basal cell carcinoma on the patient’s abdomen, including 0.6 cm margins.
10. Excision of a 2.0 cm diameter melanoma on the patient’s upper back, including 1.1 cm margins.