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The procedure described by CPT® Code 11463 involves the excision of skin and subcutaneous tissue in the inguinal region, specifically targeting 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, also known as fistulas, is common in the inguinal area. Surgical intervention is primarily indicated for severe cases of suppurative hidradenitis, where extensive excision of the affected skin and subcutaneous tissue is necessary. During the procedure, the surgeon removes the skin and subcutaneous tissue overlying the apocrine glands, ensuring that any fistulous tracts are also excised. Unlike CPT® Code 11462, which allows for simpler closure techniques, CPT® Code 11463 necessitates a complex repair. This complex repair may involve extensive undermining of the tissue, the use of stents, or retention sutures to ensure proper healing. In some instances, additional procedures such as skin grafts or flaps may be required to adequately close the surgical wound, highlighting the complexity and severity of the condition being treated.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure coded as CPT® 11463 is indicated for the treatment of hidradenitis in the inguinal region, particularly in cases where the condition has progressed to suppurative hidradenitis. The following conditions warrant this surgical intervention:
The surgical procedure associated with CPT® Code 11463 involves several critical steps to ensure effective treatment of hidradenitis:
Following the procedure coded as CPT® 11463, patients can expect specific post-operative care and recovery considerations. It is essential to monitor the surgical site for signs of infection, proper healing, and any complications that may arise. Patients may be advised to keep the area clean and dry, and to follow specific wound care instructions provided by the healthcare team. Pain management may be necessary, and patients should be informed about the signs of potential complications, such as increased redness, swelling, or discharge from the surgical site. Follow-up appointments will be scheduled to assess healing and to determine if any further interventions are required.
| Short Descr | EXC SKN HDRDNT ING COMPLEX | Medium Descr | EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR | Long Descr | Excision of skin and subcutaneous tissue for hidradenitis, inguinal; 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 |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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 |
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| 2024-01-01 | Changed | Short Description changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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