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The CPT® Code 40520 refers to the excision of a lip lesion using a V-excision technique, followed by primary direct linear closure. This procedure is specifically designed for the removal of small lesions, scars, or defects located on the lip. The process begins with the physician marking the planned incision lines on the lip using a surgical marking pen, ensuring that the incision will encompass a margin of healthy tissue surrounding the lesion to promote optimal healing and cosmetic results. Prior to the incision, local anesthesia, often combined with epinephrine, is administered to minimize discomfort and control bleeding during the procedure. The V-excision technique involves making a V-shaped incision that extends through the vermilion (the colored part of the lip) down to the white part of the lip, allowing for the complete excision of the targeted tissue. After the lesion is removed, the surgical wound is meticulously closed with sutures in a direct linear manner, ensuring that the vermilion border is properly aligned for aesthetic purposes. This procedure is essential for addressing various lip conditions while maintaining the functional and cosmetic integrity of the lip structure.
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The procedure described by CPT® Code 40520 is indicated for the excision of small lesions, scars, or defects located on the lip. These indications may include:
The procedure for CPT® Code 40520 involves several key steps, which are detailed as follows:
Post-procedure care for CPT® Code 40520 includes monitoring the surgical site for any signs of infection or complications. Patients are typically advised to keep the area clean and may be given specific instructions regarding wound care. Pain management may be necessary, and the physician may prescribe analgesics as needed. Patients should also be informed about the importance of avoiding activities that could stress the surgical site, such as vigorous physical activity or excessive lip movement, during the initial healing phase. Follow-up appointments may be scheduled to assess healing and remove sutures if non-absorbable materials were used.
| Short Descr | PARTIAL EXCISION OF LIP | Medium Descr | EXC LIP V-EXC W/PRIM DIR LINR CLSR | Long Descr | Excision of lip; V-excision with primary direct linear closure | 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) | 1 - Statutory 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) | P5E - Ambulatory procedures - other | MUE | 2 | CCS Clinical Classification | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 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). | 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. | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| Pre-1990 | Added | Code added. |
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