How To Use CPT Code 11400

CPT 11400 refers to the excision of a benign lesion, excluding skin tags, on the trunk, arms, or legs with a diameter of 0.5 cm or less, including margins. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11400 procedures.

1. What is CPT 11400?

CPT 11400 is a medical billing code used to describe the excision of a benign lesion, excluding skin tags, on the trunk, arms, or legs with a diameter of 0.5 cm or less, including margins. This code is used by medical professionals to accurately document and bill for this specific procedure.

2. 11400 CPT code description

The official description of CPT code 11400 is: “Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less.”

3. Procedure

The CPT 11400 procedure involves the following steps:

1. The patient is appropriately prepped, and the area is anesthetized.
2. The provider holds a scalpel or other bladed instrument perpendicular to the benign lesion, not a skin tag, measuring 0.5 cm or less in diameter, including margins, on the trunk, arms, or legs.
3. The provider excises down into the subcutaneous tissue in an elliptical, wedge, or circular shape to remove the entire lesion.
4. The specimen may be submitted to a laboratory for analysis.
5. The provider checks for bleeding and then closes the wound in a single layer.

4. Qualifying circumstances

Patients eligible to receive CPT code 11400 services are those with a benign lesion, excluding skin tags, on the trunk, arms, or legs with a diameter of 0.5 cm or less, including margins. The lesion must be noncancerous and not listed elsewhere in the CPT code system.

5. When to use CPT code 11400

It is appropriate to bill the 11400 CPT code when a medical professional performs the excision of a benign lesion, excluding skin tags, on the trunk, arms, or legs with a diameter of 0.5 cm or less, including margins. The code should be used to accurately document and bill for this specific procedure.

6. Documentation requirements

To support a claim for CPT 11400, the following information needs to be documented:

• Patient’s medical history and physical examination findings
• Indication for the procedure, including the size, location, and appearance of the lesion
• Details of the procedure, including anesthesia, excision technique, and wound closure
• Any complications encountered during the procedure
• Pathology report, if the specimen was submitted for analysis
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 11400, keep in mind the following guidelines and rules:

• For the same procedure on a lesion with a diameter of 0.6 to 1 cm, see CPT 11401.
• For the same procedure on a lesion with a diameter of 1.1 to 2.0 cm, see CPT 11402.
• For the same procedure on a lesion with a diameter of 2.1 to 3.0 cm, see CPT 11403.
• For the same procedure on a lesion with a diameter of 3.1 to 4.0 cm, see CPT 11404.
• For the same procedure on a lesion with a diameter of over 4.0 cm, see CPT 11406.
• To differentiate between codes for excision and shaving, look at the removal’s depth. Excision involves full thickness, while shaving involves sharp removal without a full-thickness dermal excision.
• If a provider excises multiple lesions of different diameters, apply modifier 59, Distinct procedural service, to the code for the second lesion.

8. Historical information

CPT 11400 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, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion diameter 0.5 cm or less.”

9. Similar codes to CPT 11400

Five similar codes to CPT 11400 differentiate as follows:

• CPT 11401 is used for excision of a benign lesion with a diameter of 0.6 to 1 cm.
• CPT 11402 is used for excision of a benign lesion with a diameter of 1.1 to 2.0 cm.
• CPT 11403 is used for excision of a benign lesion with a diameter of 2.1 to 3.0 cm.
• CPT 11404 is used for excision of a benign lesion with a diameter of 3.1 to 4.0 cm.
• CPT 11406 is used for excision of a benign lesion with a diameter of over 4.0 cm.

10. Examples

Here are 10 detailed examples of CPT code 11400 procedures:

1. Excision of a 0.5 cm diameter benign mole on the patient’s upper arm.
2. Removal of a 0.4 cm diameter seborrheic keratosis on the patient’s back.
3. Excision of a 0.3 cm diameter benign nevus on the patient’s thigh.
4. Removal of a 0.5 cm diameter lipoma on the patient’s forearm.
5. Excision of a 0.2 cm diameter dermatofibroma on the patient’s lower leg.
6. Removal of a 0.5 cm diameter epidermoid cyst on the patient’s shoulder.
7. Excision of a 0.4 cm diameter pyogenic granuloma on the patient’s chest.
8. Removal of a 0.3 cm diameter benign melanocytic nevus on the patient’s abdomen.
9. Excision of a 0.5 cm diameter pilomatricoma on the patient’s upper leg.
10. Removal of a 0.2 cm diameter benign fibrous papule on the patient’s lower arm.