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Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less

CPT4 code

Name of the Procedure:

Destruction of Malignant Lesion (e.g., Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement)

Summary

This procedure involves removing small malignant lesions (0.5 cm or less in diameter) found on sensitive areas such as the scalp, neck, hands, feet, and genitalia. Techniques such as laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement are used to destroy the cancerous tissue.

Purpose

Medical Condition:

The procedure addresses the presence of small malignant lesions, which could be early-stage skin cancer or other forms of localized malignancies.

Goals:
  • To remove cancerous cells and prevent the spread of malignancy.
  • To preserve the function and appearance of the affected area.

Indications

Symptoms or Conditions:
  • Small skin lesions that have been diagnosed as malignant.
  • Lesions located on the scalp, neck, hands, feet, and genitalia that are 0.5 cm or less in diameter. ##### Patient Criteria:
  • Patients diagnosed with early-stage skin cancer or other localized malignancies.
  • Patients for whom less invasive treatments have been insufficient or inappropriate.

Preparation

Pre-procedure Instructions:
  • Follow fasting guidelines if anesthesia is planned.
  • Adjust medications as directed by the healthcare provider.
  • Avoid applying creams or lotions to the affected area. ##### Diagnostic Tests:
  • Biopsy of the lesion to confirm malignancy.
  • Blood tests and imaging studies as required for surgical planning.

Procedure Description

  • The patient is positioned to allow access to the lesion.
  • Local anesthesia or sedation might be administered to minimize discomfort.
  • The specific technique (e.g., laser, electrosurgery, cryosurgery) is chosen based on the lesion's characteristics.
  • The malignant lesion is carefully destroyed or removed using the selected method.
  • The area is cleaned and dressed to promote healing.
Tools and Equipment:
  • Laser devices, electrosurgical units, cryotherapy probes, chemotherapeutic agents, or curettes.
Anesthesia:
  • Typically involves local anesthesia; general anesthesia is rare and based on patient needs and lesion location.

Duration

The procedure usually takes between 15 to 45 minutes, depending on the lesion's size and complexity.

Setting

This procedure is typically performed in an outpatient clinic, dermatology office, or surgical center.

Personnel

  • Dermatologist or surgeon.
  • Nursing staff.
  • Anesthesiologist or nurse anesthetist if sedation is used.

Risks and Complications

Common Risks:
  • Pain and discomfort at the site.
  • Mild bleeding or swelling. ##### Rare Risks:
  • Infection.
  • Scarring or changes in skin pigmentation.
  • Nerve damage in sensitive areas. ##### Complications Management:
  • Antibiotics for infection.
  • Follow-up care for proper wound healing.

Benefits

  • Effective removal of malignant tissue.
  • Minimally invasive with quick recovery time.
  • High success rate for early-stage malignancies.

Recovery

Post-Procedure Care:
  • Keep the area clean and dry.
  • Follow wound care instructions provided by the healthcare team.
  • Pain management with over-the-counter pain relievers as advised. ##### Recovery Time:
  • Typically, 1 to 2 weeks for the area to heal.
  • Avoid strenuous activity until healing is complete. ##### Follow-Up:
  • Scheduled to monitor healing and check for recurrence.

Alternatives

Other Options:
  • Surgical excision.
  • Radiation therapy.
  • Topical treatments (e.g., imiquimod cream). ##### Pros and Cons:
  • Surgical excision: More invasive but can ensure complete removal.
  • Radiation therapy: Non-surgical but may require multiple sessions.
  • Topical treatments: Less invasive but might take longer to show results.

Patient Experience

During Procedure:
  • Local anesthesia minimizes pain; slight pressure or mild discomfort may be felt. ##### After Procedure:
  • Possible mild pain and swelling.
  • Relief from malignancy symptoms. ##### Pain Management:
  • Over-the-counter pain relief as needed.
  • Adherence to aftercare instructions to enhance comfort and healing.

Medical Policies and Guidelines for Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less

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