How To Use cpt 11620

cpt 11620 describes the excision of a malignant lesion, including margins, with a diameter of 0.5 cm or less, from the skin of the scalp, neck, hands, feet, or genitalia. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 11620.

1. What is cpt 11620?

cpt 11620 is a code used to describe the excision of a malignant lesion, including margins, with a diameter of 0.5 cm or less, from the skin of the scalp, neck, hands, feet, or genitalia. This procedure involves the removal of the cancerous lesion along with a margin of healthy tissue to ensure complete removal. The excision is performed by a healthcare provider after appropriate preparation and local anesthesia.

2. Official Description

The official description of cpt 11620 is: ‘Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 0.5 cm or less.’

3. Procedure

The procedure for cpt 11620 involves the following steps:

1. The healthcare provider prepares the patient and administers local anesthesia to 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.
4. The entire malignant lesion, including the previously outlined margins, is excised.
5. All margins are cleaned, bleeding is controlled, and the wound is closed with sutures.
6. 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 needed.

4. Qualifying circumstances

cpt 11620 is used for the excision of malignant lesions with a diameter of 0.5 cm or less from specific areas of the body, including the scalp, neck, hands, feet, or genitalia. These lesions can include melanoma, squamous cell carcinoma, or basal cell carcinoma. The procedure is performed when the lesion is locally invasive and has the potential to spread if left untreated.

5. When to use cpt code 11620

cpt 11620 should be used when a healthcare provider performs the excision of a malignant lesion, including margins, with a diameter of 0.5 cm or less from the specified areas of the body. It is important to accurately document the size of the lesion and ensure that it meets the criteria for this specific code.

6. Documentation requirements

To support a claim for cpt 11620, the healthcare provider must document the following information:

• The diagnosis of a malignant lesion
• The size of the lesion, which should be 0.5 cm or less in diameter
• The specific location of the lesion (scalp, neck, hands, feet, or genitalia)
• The use of local anesthesia
• The identification and outlining of a margin of healthy tissue
• The full-thickness incision and excision of the lesion
• The cleaning of margins, control of bleeding, and closure of the wound
• 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 11620, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The excision should be performed on a malignant lesion with a diameter of 0.5 cm or less from the specified areas of the body. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

cpt 11620 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 11620

There are several similar codes to cpt 11620 that are used for excision of malignant lesions with different diameters or from different areas of the body. Some similar codes include:

• cpt 11621: Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 0.6 to 1.0 cm
• cpt 11622: Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 1.1 to 2.0 cm
• cpt 11623: Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 2.1 to 3.0 cm
• cpt 11624: Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 3.1 to 4.0 cm
• cpt 11626: Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter over 4.0 cm

9. Examples

Here are some examples of cases where cpt 11620 may be used:

1. A healthcare provider performs the excision of a 0.3 cm diameter malignant lesion from the scalp of a patient.
2. A patient presents with a 0.4 cm diameter malignant lesion on their hand, and a healthcare provider performs the excision, including margins.
3. A healthcare provider performs the excision of a 0.5 cm diameter malignant lesion from the genitalia of a patient.
4. A patient has a 0.2 cm diameter malignant lesion on their neck, and a healthcare provider performs the excision, including margins.
5. A healthcare provider performs the excision of a 0.4 cm diameter malignant lesion from the foot of a patient.