Can D7414 be used for lesions in areas other than the oral cavity?

D7414 is specifically for lesions in the oral cavity or maxillofacial region. Other codes may apply for different anatomical locations.

Is pre-authorization required for D7414?

Pre-authorization may be required depending on the patient's insurance plan. It's important to verify coverage before proceeding.

Are there any post-operative care requirements for D7414?

Yes, post-operative care is crucial and should include monitoring for complications, managing pain, and ensuring proper healing.

What should be included in the surgical report for D7414?

The report should include details of the lesion size, location, surgical technique, and confirmation of complete excision.

D7414

Excision of Malignant Lesion - CDT Code Guide

Oral & Maxillofacial Surgery/Excision of Soft Tissue Lesions

Overview

CDT code D7414 refers to the excision of a malignant lesion greater than 1.25 cm in size. This procedure is typically performed by an oral and maxillofacial surgeon and involves the surgical removal of cancerous tissue from the oral cavity or surrounding areas. The goal is to ensure complete excision of the malignant tissue while preserving as much healthy tissue as possible. This procedure is crucial in the management of oral cancers and may be part of a broader treatment plan that includes radiation or chemotherapy. Typical scenarios for using this code include cases where a biopsy has confirmed malignancy, and the lesion size exceeds 1.25 cm, necessitating surgical intervention.

When to Use This Code

Confirmed malignant lesion in the oral cavity larger than 1.25 cm
Pre-surgical planning indicates the need for wide excision due to lesion size
Lesion located in a challenging area requiring specialized surgical expertise
Part of a comprehensive cancer treatment plan involving surgical excision
Re-excision required due to incomplete margins from a previous procedure

Documentation Requirements

Detailed clinical notes confirming the diagnosis of a malignant lesion
Pre-operative imaging or biopsy results supporting the size and malignancy
Surgical report detailing the procedure, including size and location of the lesion
Pathology report confirming the excision of malignant tissue
Post-operative care instructions and follow-up plan

Billing Considerations

When billing for D7414, ensure that the documentation clearly supports the size and malignancy of the lesion. This code may be used in conjunction with other surgical codes if additional procedures are performed. Be aware of payer-specific guidelines regarding pre-authorization for surgical excisions. Common modifiers such as -22 for increased procedural services or -58 for staged or related procedures may apply. Verify with the patient's insurance for coverage specifics, as some plans may require prior authorization or have limitations on surgical excisions.

Related CDT Codes

D7410 D7411 D7412 D7413 D7415

Frequently Asked Questions

D7414 is used for excising malignant lesions greater than 1.25 cm, while D7410 is for benign lesions of any size.

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