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Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; 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) - Lesion Diameter 0.5 cm or Less

Summary

This procedure involves the removal of cancerous skin lesions on the face, ears, eyelids, nose, lips, or mucous membrane, which are 0.5 cm in diameter or smaller. Various techniques like laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement are used to destroy the abnormal tissue.

Purpose

The procedure addresses small-sized malignant skin lesions to prevent cancer from spreading or causing further damage. The goal is to completely eradicate the cancerous tissue while minimizing damage to surrounding healthy tissue.

Indications

  • Diagnosis of a malignant skin lesion ≤ 0.5 cm in diameter on the face, ears, eyelids, nose, lips, or mucous membrane.
  • Patients who have had a biopsy confirming malignancy.
  • Lesions that have not responded to other forms of treatment.

Preparation

  • Patients may need to fast for a certain period before the procedure if sedation or anesthesia is used.
  • Adjustments to medications, especially blood thinners, may be necessary.
  • Pre-procedure assessments may include blood tests and imaging studies.

Procedure Description

  1. Local anesthesia or topical numbing is applied to the area.
  2. Depending on the technique:
    • Laser Surgery: A laser beam targets and destroys the malignant cells.
    • Electrosurgery: Electrical currents are used to burn off the lesion.
    • Cryosurgery: Liquid nitrogen freezes and destroys the lesion.
    • Chemosurgery: Chemical agents are applied to dissolve the lesion.
    • Surgical Curettement: A curette (spoon-shaped instrument) scrapes off the lesion.
  3. The area is then cleaned and dressed.

Duration

The procedure typically takes 15 to 30 minutes.

Setting

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: Minor bleeding, infection, scarring, and pain at the treatment site.
  • Rare risks: Significant scarring, recurrence of the lesion, allergic reactions to anesthesia, and changes in skin sensation.

Benefits

  • Effective removal of cancerous lesions.
  • Minimal tissue damage to surrounding areas.
  • Typically quick recovery and low risk of significant complications.

Recovery

  • Post-procedure care includes keeping the area clean and dry.
  • Apply prescribed ointments or dressings.
  • Follow-up appointments to monitor healing and ensure complete lesion removal.
  • Recovery time is usually a few days to a week, with minimal restrictions on daily activities.

Alternatives

  • Mohs surgery: More precise but time-consuming and typically used for larger, deeper lesions.
  • Radiation therapy: Non-invasive but requires multiple sessions and may have more side effects.

Patient Experience

  • Patients may feel slight discomfort during anesthesia application.
  • Some pain or soreness at the treatment site post-procedure, manageable with over-the-counter pain relievers.
  • Quick return to normal activities with proper aftercare.

Medical Policies and Guidelines for Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less

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