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Injection, intralesional; up to and including 7 lesions

CPT4 code

Name of the Procedure:

Injection, intralesional; up to and including 7 lesions

Summary

Intralesional injection involves the direct injection of medication into a lesion or affected area on the skin. This procedure can target up to seven lesions to treat conditions like warts, cysts, or certain types of skin cancer.

Purpose

Intralesional injection is used to treat localized skin problems such as warts, keloids, cysts, or precancerous skin lesions. The goal of the procedure is to deliver medication directly to the affected area to reduce symptoms, promote healing, and sometimes to shrink or eliminate the lesions.

Indications

  • Persistent warts or cysts that do not respond to other treatments
  • Keloid or hypertrophic scars
  • Localized skin inflammation
  • Certain types of localized skin cancer or precancerous lesions

    Suitable for patients whose specific lesions are causing discomfort, cosmetic concerns, or health risks and are unresponsive to simpler treatment methods.

Preparation

  • Patients may be advised to avoid certain medications (like blood thinners) before the procedure.
  • It’s usually unnecessary to fast or perform other significant preparations.
  • A thorough consultation and examination by a healthcare provider are necessary to determine the appropriateness of the procedure.

Procedure Description

  1. The skin around the lesion is cleaned and sterilized.
  2. Local anesthesia may be applied to minimize discomfort.
  3. Using a fine needle, the healthcare provider injects the appropriate medication directly into the lesion.
  4. This process is repeated for each lesion, up to a total of seven.
  5. Pressure may be applied to the site briefly to minimize bleeding.

Tools and equipment typically include syringes, fine needles, and sterilizing agents. Local anesthesia is commonly used to ensure patient comfort.

Duration

The procedure typically takes between 15 to 30 minutes, depending on the number and complexity of the lesions.

Setting

This procedure is usually performed in an outpatient setting, such as a dermatology clinic or an outpatient surgical center.

Personnel

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

Risks and Complications

  • Pain or discomfort at the injection site
  • Infection
  • Bleeding or bruising
  • Allergic reaction to the medication
  • Temporary swelling or redness

Benefits

  • Directly targets problem areas with higher efficacy
  • Minimized systemic side effects compared to oral medications
  • Quick procedure with minimal downtime
  • Can enhance healing and improve cosmetic outcomes

Recovery

  • Patients can typically resume normal activities immediately.
  • Instructions may include keeping the area clean and avoiding strenuous activity for a short period.
  • Any discomfort can usually be managed with over-the-counter pain relievers.
  • Follow-up appointments may be necessary to assess the effectiveness of the treatment.

Alternatives

  • Topical treatments
  • Cryotherapy (freezing the lesion)
  • Laser therapy
  • Surgical removal

Each alternative has its own set of pros and cons, ranging from less invasive topical treatments with lower efficacy to more invasive surgical options with greater risk.

Patient Experience

Patients often feel a slight sting or mild discomfort from the injection, particularly if no anesthesia is used. Post-procedure, some soreness or mild swelling may occur at the injection sites. Pain management typically includes over-the-counter analgesics, and most patients can comfortably resume regular activities the same day.

Medical Policies and Guidelines for Injection, intralesional; up to and including 7 lesions

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