How To Use cpt 11606

cpt 11606 describes the excision of a malignant lesion, including margins, that is over 4.0 cm in diameter from the skin of the trunk, arms, or legs. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11606.

1. What is cpt 11606?

cpt 11606 is a code used to describe the excision of a malignant lesion, including margins, that is over 4.0 cm in diameter from the skin of the trunk, arms, or legs. This procedure involves the removal of the entire lesion, along with a margin of healthy tissue, to ensure complete removal of the cancerous cells. It is typically performed by a healthcare provider after appropriate preparation and local anesthesia.

2. Official Description

The official description of cpt 11606 is: ‘Excision, malignant lesion including margins, trunk, arms, or legs excised diameter over 4.0 cm.’

3. Procedure

The procedure for cpt 11606 involves several steps:

1. The healthcare provider prepares the patient and administers local anesthesia to numb the area.
2. A margin of healthy tissue is identified and outlined with a marking pen.
3. The provider makes a full-thickness incision through the skin, encompassing the entire lesion and the previously outlined margins.
4. The lesion, along with the margins, is excised (cut out) from the skin.
5. All margins are cleaned and bleeding is controlled.
6. The wound is closed with sutures.
7. If necessary, the excised lesion may be sent to a laboratory for further evaluation or a frozen section may be performed to determine if additional excision of margins is required.

4. Qualifying circumstances

cpt 11606 is used for the excision of malignant lesions that are over 4.0 cm in diameter from the skin of the trunk, arms, or legs. These lesions can include melanoma, squamous cell carcinoma, or basal cell carcinoma. The procedure is typically performed by a healthcare provider who has determined that the lesion is cancerous and requires excision. It is important to note that malignant lesions are locally invasive and have the potential to spread to other parts of the body if left untreated.

5. When to use cpt code 11606

cpt 11606 should be used when a healthcare provider performs the excision of a malignant lesion, including margins, that is over 4.0 cm in diameter from the skin of the trunk, arms, or legs. It is important to accurately document the size of the lesion and ensure that it meets the criteria for this specific code. If the lesion is smaller in diameter, different codes should be used to accurately reflect the size of the excised lesion.

6. Documentation requirements

To support a claim for cpt 11606, the healthcare provider must document the following information:

• The diagnosis of a malignant lesion
• The size of the lesion, confirming that it is over 4.0 cm in diameter
• The location of the lesion (trunk, arms, or legs)
• The use of local anesthesia
• The identification and outlining of margins
• The full-thickness incision and excision of the lesion
• The cleaning of margins and control of bleeding
• The closure of the wound with sutures
• Any additional procedures performed, such as sending the excised lesion for further evaluation or performing a frozen section
• The signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 11606, it is important to ensure that the excision is performed on a malignant lesion that meets the criteria for this specific code. The procedure should be accurately documented and coded to reflect the size and location of the excised lesion. It is also important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

cpt 11606 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to cpt 11606

There are several similar codes to cpt 11606 that are used for excision of malignant lesions on different parts of the body and of different sizes. Some similar codes include:

• cpt 11600: Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
• cpt 11601: Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm
• cpt 11602: Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm
• cpt 11603: Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm
• cpt 11604: Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm

9. Examples

Here are some examples of cases where cpt 11606 may be used:

1. A healthcare provider performs the excision of a malignant melanoma, including margins, that is over 4.0 cm in diameter from the trunk of a patient.
2. A healthcare provider excises a squamous cell carcinoma, including margins, that is over 4.0 cm in diameter from the leg of a patient.
3. A healthcare provider performs the excision of a basal cell carcinoma, including margins, that is over 4.0 cm in diameter from the arm of a patient.
4. A healthcare provider removes a malignant lesion, including margins, that is over 4.0 cm in diameter from the leg of a patient, and sends it for further evaluation in the laboratory.
5. A healthcare provider excises a malignant lesion, including margins, that is over 4.0 cm in diameter from the trunk of a patient and performs a frozen section to ensure complete removal of the cancerous cells.