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Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm

CPT4 code

Name of the Procedure:

Shaving of Epidermal or Dermal Lesion, Single Lesion, Scalp, Neck, Hands, Feet, Genitalia (Lesion Diameter Over 2.0 cm)

Summary

This procedure involves the shaving or removal of a lesion on the scalp, neck, hands, feet, or genitalia that is larger than 2.0 centimeters in diameter. The goal is to remove the lesion without making a full-thickness cut, which can help with both diagnosis and treatment.

Purpose

The procedure addresses suspicious, bothersome, or cosmetically undesirable skin lesions. The goals are to confirm a diagnosis (if the lesion is biopsied), alleviate symptoms, or improve the skin's appearance.

Indications

  • Visible skin lesions that are painful, itchy, or growing
  • Lesions suspected to be pre-cancerous or cancerous
  • Cosmetic concerns affecting the patient's quality of life
  • Lesions interfering with daily activities or clothing

Preparation

  • May need to stop certain medications (e.g., blood thinners)
  • Clean the area thoroughly before the procedure
  • Potential diagnostic tests, like a biopsy, may be done beforehand

Procedure Description

  1. The area around the lesion is cleaned and sterilized.
  2. Local anesthesia is administered to numb the treatment area.
  3. A sterile razor blade, scalpel, or similar instrument is used to shave off the lesion at the skin surface.
  4. Hemostasis (stopping any bleeding) is achieved, often with a cautery device or application of pressure.
  5. The area is bandaged.

Duration

Typically, the procedure takes about 15 to 30 minutes.

Setting

The procedure is generally performed in an outpatient clinic or a dermatologist's office.

Personnel

  • Dermatologist or a trained healthcare provider
  • Medical assistant or nurse

Risks and Complications

  • Bleeding
  • Infection
  • Scarring
  • Temporary or permanent changes in skin color
  • Recurrence of the lesion

Benefits

  • Removal of troubling lesions
  • Immediate cosmetic improvement
  • Rapid relief of symptoms
  • Potential for accurate diagnosis if a biopsy is performed

Recovery

  • Keep the area clean and dry for a specified period
  • Avoid strenuous activity that might affect the treated area
  • Follow-up visit might be necessary to assess healing
  • Over-the-counter pain medications can be used for discomfort
  • Typically, healing occurs within a week or two

Alternatives

  • Full excisional biopsy, which involves removing the entire lesion with a margin of normal skin
  • Laser therapy
  • Cryotherapy (freezing the lesion)
  • Topical treatments

Each alternative has different pros and cons regarding precision, recovery time, and potential scarring.

Patient Experience

During the procedure, patients might feel a slight prick from the local anesthetic but should not feel pain. Post-procedure, there might be minor discomfort, manageable with pain relievers. Proper wound care is essential to prevent infection and ensure optimal healing.

Medical Policies and Guidelines for Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm

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