Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
RedactPHI
HIPAA-Compliant PHI Redaction
DetectICD10CM
ICD-10-CM Code Detection
Log in Register free account
1 code page views remaining. Guest accounts are limited to 1 page view. Register free account to get 5 more views.
Log in Register free account

Official Description

Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 11471 involves the excision of skin and subcutaneous tissue specifically for the treatment of hidradenitis located in the perianal, perineal, or umbilical regions. 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 affected areas. Surgical intervention is primarily indicated for suppurative hidradenitis, where the excision involves removing the skin and subcutaneous tissue that overlies the apocrine glands, along with any fistulous tracts that may be present. The extent of the excision can vary, with severe cases necessitating the removal of a significant amount of tissue. Following the excision, the wound is typically closed using a complex repair technique, which may involve more than just a layered closure. This complex repair can include extensive undermining, 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.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 11471 is indicated for the treatment of hidradenitis in specific anatomical regions. The following conditions warrant this surgical intervention:

  • Hidradenitis Suppurativa - A chronic inflammatory skin condition characterized by painful, swollen lesions and abscesses in the areas where apocrine glands are located, particularly in the perianal, perineal, or umbilical regions.
  • Presence of Fistulas - The development of draining sinus tracts or fistulas in the affected areas, which may complicate the condition and require surgical excision for resolution.
  • Severe Cases - Instances of severe suppurative hidradenitis that necessitate extensive removal of skin and subcutaneous tissue to alleviate symptoms and prevent further complications.

2. Procedure

The procedure for CPT® Code 11471 involves several critical steps to ensure effective treatment of hidradenitis. The following outlines the procedural steps:

  • Step 1: Anesthesia Administration - The procedure begins with the administration of appropriate anesthesia to ensure patient comfort during the excision. This may involve local anesthesia to numb the specific area or general anesthesia depending on the extent of the surgery and patient needs.
  • Step 2: Excision of Affected Tissue - The surgeon carefully excises the skin and subcutaneous tissue overlying the apocrine glands in the perianal, perineal, or umbilical region. This step is crucial for removing the inflamed and infected tissue associated with hidradenitis, including any surrounding subcutaneous tissue that may be affected.
  • Step 3: Identification and Removal of Fistulous Tracts - If present, any draining sinus tracts or fistulas are identified and excised. This is an essential part of the procedure to prevent recurrence of the condition and to promote healing.
  • Step 4: Wound Closure - After the excision, the surgical site is closed using a complex repair technique. This may involve extensive undermining of the surrounding tissue, the application of stents, or the use of retention sutures to secure the closure. The complexity of the repair is necessary to ensure proper healing and to minimize complications.
  • Step 5: Post-Operative Care Instructions - Following the closure, the surgeon provides specific post-operative care instructions to the patient, which may include wound care, signs of infection to monitor, and follow-up appointments to assess healing.

3. Post-Procedure

Post-procedure care for patients undergoing the excision of skin and subcutaneous tissue for hidradenitis includes several important considerations. Patients are typically advised to keep the surgical site clean and dry to prevent infection. They may be instructed to change dressings regularly and to monitor for any signs of complications, such as increased redness, swelling, or discharge from the wound. Pain management may be addressed with prescribed medications or over-the-counter pain relievers as needed. Follow-up appointments are essential to evaluate the healing process and to determine if any further interventions, such as additional surgeries or therapies, are necessary. Patients should also be informed about lifestyle modifications that may help manage hidradenitis and reduce the risk of recurrence.

Short Descr EXC SKN H/P/P/U COMPLEX
Medium Descr EXCISION H/P/P/U COMPLEX REPAIR
Long Descr Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; 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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
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) P5A - Ambulatory procedures - skin
MUE 2
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.
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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
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)
SG Ambulatory surgical center (asc) facility service
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
Date
Action
Notes
2024-01-01 Changed Short Description changed.
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"