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Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm

CPT4 code

Name of the Procedure:

Destruction of malignant lesion (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms, or legs; lesion diameter 0.6 to 1.0 cm

Summary

This procedure involves the removal of malignant skin lesions on the trunk, arms, or legs using various techniques like laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement.

Purpose

The main goal is to eliminate cancerous lesions from the skin to prevent the spread of cancer and allow for healing and normal skin function.

Indications

This procedure is recommended for patients with skin cancer lesions on the trunk, arms, or legs that measure between 0.6 and 1.0 cm in diameter. Indications include confirmed diagnosis of malignancy through a biopsy, visible changes in skin lesions like irregular borders, color changes, and growth.

Preparation

Patients may need to avoid certain medications, such as blood thinners, before the procedure. No eating or drinking is generally required if local anesthetic is used. Sometimes diagnostic tests like blood work or imaging studies may be needed for comprehensive evaluation.

Procedure Description

  1. The area around the lesion is cleaned and sterilized.
  2. Local anesthesia is injected to numb the area.
  3. The chosen method (laser, electrosurgery, cryosurgery, etc.) is used to destroy the malignant tissue.
    • Laser Surgery: Uses focused light to remove the lesion.
    • Electrosurgery: Uses electrical current to cut and coagulate tissues.
    • Cryosurgery: Involves freezing the lesion with liquid nitrogen.
    • Chemosurgery: Uses a chemical agent to destroy cancer cells.
    • Surgical Curettement: Uses a curette to scrape away the malignant tissue.
  4. The area is then treated to promote healing, possibly covered with a sterile bandage.

Duration

The procedure usually takes between 15 and 30 minutes, depending on the technique used and the specific characteristics of the lesion.

Setting

This procedure is typically performed in an outpatient clinic, dermatologist’s office, or a surgical center.

Personnel

The procedure is carried out by a dermatologist or a surgical oncologist, often with the assistance of a nurse. An anesthesiologist may be involved if sedation or general anesthesia is required.

Risks and Complications

Common risks include infection, bleeding, and scarring. Rare complications can include nerve damage or an adverse reaction to anesthetic.

Benefits

The primary benefit is the removal of cancerous tissue to prevent further spread. Patients typically experience a resolution of the lesion and a significant decrease in cancer risk from that area.

Recovery

Post-procedure care includes keeping the area clean and dry, applying prescribed ointments, and avoiding strenuous activities. Recovery time is generally short, ranging from a few days to a few weeks, depending on the method used and the patient’s overall health.

Alternatives

Alternatives include Mohs surgery, radiation therapy, or topical treatments. Each alternative has its own risks and benefits, and suitability depends on the patient's specific condition and health status.

Patient Experience

Patients might feel some discomfort during the administration of local anesthesia but typically feel no pain during the procedure itself. Post-procedure, mild pain, swelling, and redness are common but manageable with pain relievers and proper wound care.

Medical Policies and Guidelines for Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm

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