© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 11451 involves the excision of skin and subcutaneous tissue specifically in the axillary region, commonly known as the armpit, to treat a condition known as hidradenitis. Hidradenitis is a chronic dermatological condition that manifests as swollen, painful, and inflamed lesions affecting the cutaneous apocrine glands, which are responsible for sweat production. This condition can lead to significant discomfort and may also involve the surrounding subcutaneous tissue and fascia. In cases of suppurative hidradenitis, the presence of draining sinus tracts, or fistulas, is common in the axillary area, indicating a more severe form of the disease that necessitates surgical intervention. The surgical procedure entails the excision of the affected skin and subcutaneous tissue, including the removal of any exposed fistulous tracts. In instances of severe suppurative hidradenitis, extensive excision of all involved tissues is required to adequately address the condition. The closure of the surgical wound following this excision is a critical aspect of the procedure. While CPT® Code 11450 allows for simpler closure techniques, such as single-layer or intermediate repairs, CPT® Code 11451 specifically denotes a complex repair. This complex repair involves more intricate techniques that may include extensive undermining, the use of stents, or retention sutures to ensure proper healing. Additionally, in some cases, a separately reportable skin graft or flap may be necessary to achieve optimal closure of the surgical site.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure coded under CPT® Code 11451 is indicated for the treatment of hidradenitis, particularly in cases where the condition has progressed to a suppurative state. The following conditions warrant this surgical intervention:
The procedure for CPT® Code 11451 involves several critical steps to ensure effective treatment of hidradenitis in the axillary region. The following procedural steps are outlined:
Post-procedure care following the excision of skin and subcutaneous tissue for hidradenitis is critical for recovery. Patients are typically advised to keep the surgical site clean and dry, and to follow any specific wound care instructions provided by the healthcare provider. Monitoring for signs of infection, such as increased redness, swelling, or discharge, is essential. Pain management may be necessary, and patients may be prescribed analgesics to manage discomfort. Follow-up appointments are important to assess the healing process and to address any complications that may arise. In some cases, additional treatments or interventions may be required based on the patient's recovery and the extent of the initial condition.
| Short Descr | EXC SKN HDRDNT AX COMPLEX | Medium Descr | EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR | Long Descr | Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6A - Minor procedures - skin | MUE | 1 | CCS Clinical Classification | 170 - Excision of skin lesion |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2024-01-01 | Changed | Short Description changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |