How To Use cpt 11623

cpt 11623 describes the excision of a malignant lesion, including margins, with a diameter of 2.1 to 3.0 cm 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 11623.

1. What is cpt 11623?

cpt 11623 is a code used to describe the excision of a malignant lesion, including margins, with a diameter of 2.1 to 3.0 cm from the skin of the scalp, neck, hands, feet, or genitalia. This procedure involves the removal of the entire lesion, along with a margin of healthy tissue, to ensure complete removal of the cancerous cells. The excision is performed by a healthcare provider after appropriate preparation and local anesthesia.

2. Official Description

The official description of cpt 11623 is: ‘Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 2.1 to 3.0 cm.’

3. Procedure

The procedure for cpt 11623 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 lesion, including the previously outlined margins, is excised.
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 needed.

4. Qualifying circumstances

cpt 11623 is used for the excision of malignant lesions with a diameter of 2.1 to 3.0 cm from the skin of the scalp, neck, hands, feet, or genitalia. These lesions can include melanoma, squamous cell carcinoma, or basal cell carcinoma. The procedure is performed on patients who have been diagnosed with a malignant lesion in one of these areas and require surgical removal.

5. When to use cpt code 11623

cpt 11623 should be used when a healthcare provider performs the excision of a malignant lesion, including margins, with a diameter of 2.1 to 3.0 cm from the skin of the scalp, neck, hands, feet, or genitalia. This code should be used for each individual lesion excised that meets the specified criteria.

6. Documentation requirements

To support a claim for cpt 11623, the healthcare provider must document the following information:

• Patient’s diagnosis of a malignant lesion
• Size of the lesion, including the diameter
• Location of the lesion (scalp, neck, hands, feet, or genitalia)
• Details of the excision procedure, including the use of local anesthesia
• Description of the margins excised
• Any additional procedures performed, such as a frozen section or further excision of margins
• Pathology results, if available
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for cpt 11623, ensure that the excision is performed on a malignant lesion with a diameter of 2.1 to 3.0 cm from the specified areas (scalp, neck, hands, feet, or genitalia). It is important to accurately document the details of the procedure and provide any necessary supporting documentation, such as pathology results. Modifier 59 may be used if multiple lesions of different diameters are excised during the same session.

8. Historical information

cpt 11623 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 11623

Five similar codes to cpt 11623 include:

• cpt 11620: Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia excised diameter 0.5 cm or less
• 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 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

1. A healthcare provider excises a malignant lesion, including margins, with a diameter of 2.5 cm from the scalp of a patient.
2. A patient undergoes the excision of a malignant lesion, including margins, with a diameter of 2.8 cm from their genitalia.
3. A healthcare provider performs the excision of a malignant lesion, including margins, with a diameter of 2.2 cm from the neck of a patient.
4. A patient undergoes the excision of a malignant lesion, including margins, with a diameter of 2.7 cm from their hands.
5. A healthcare provider excises a malignant lesion, including margins, with a diameter of 2.3 cm from the feet of a patient.
6. A patient undergoes the excision of a malignant lesion, including margins, with a diameter of 2.6 cm from their scalp.
7. A healthcare provider performs the excision of a malignant lesion, including margins, with a diameter of 2.4 cm from the genitalia of a patient.
8. A patient undergoes the excision of a malignant lesion, including margins, with a diameter of 2.9 cm from their neck.
9. A healthcare provider excises a malignant lesion, including margins, with a diameter of 2.1 cm from the hands of a patient.
10. A patient undergoes the excision of a malignant lesion, including margins, with a diameter of 3.0 cm from their feet.