11300

Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less

CPT code 11300 describes the surgical procedure for the removal of a single epidermal or dermal lesion located on the trunk, arms, or legs, measuring 0.5 cm or less in diameter, using a shaving technique. The shaving of a lesion involves the horizontal slicing or transverse removal of epidermal and dermal lesions without a full-thickness dermal excision. This procedure is typically performed to remove benign or premalignant skin lesions that are elevated above the skin surface, such as seborrheic keratoses, skin tags, warts, or nevi, when conservative treatment is ineffective or when histologic evaluation is necessary, although not exclusively for biopsy purposes. The provider administers a local anesthetic to numb the area. Using a surgical blade (such as a #15 scalpel blade), a Derma blade, or scissors, the physician horizontally shaves or slices the lesion flush with the surrounding skin or slightly below the epidermal-dermal junction. The depth of the shave usually extends into the upper portions of the dermis but does not encompass the full thickness of the dermis. Following the removal, the wound does not require standard suturing; instead, hemostasis is achieved through the application of topical chemical agents (e.g., aluminum chloride, Monsel's solution) or via electrocautery. The excised tissue is typically sent to pathology for microscopic evaluation. It is crucial to distinguish this shaving procedure from excision, which involves a full-thickness dermal removal and usually requires suturing. The selection of CPT 11300 is specifically contingent on three factors: the technique (shaving), the anatomical location (trunk, arms, or legs), and the lesion diameter (0.5 cm or less). Proper measurement of the lesion prior to removal is essential, as the code is based solely on the lesion's diameter, not the margins or the final defect size. In the clinical setting, accurate documentation must clearly state the anatomical site, the precise pre-procedure diameter of the lesion, and the depth of removal (partial thickness versus full thickness) to ensure compliance with billing and coding regulations and to differentiate it from other lesion removal methods such as destruction or formal excision.

Clinical Indications

  • Presence of a benign, elevated skin lesion (e.g., seborrheic keratosis, intradermal nevus, wart) located on the trunk, arms, or legs.
  • Bothersome lesions that are prone to frequent trauma, bleeding, or irritation from clothing.
  • Diagnostic evaluation of a clinically ambiguous epidermal or dermal lesion to rule out malignancy, when partial thickness removal is deemed appropriate.
  • Premalignant lesions where a superficial shave removal is an accepted therapeutic and diagnostic modality.
  • A single lesion measuring exactly 0.5 cm or less at its greatest pre-procedure clinical diameter.

Procedure Steps

  1. Identify and closely examine the lesion to confirm its anatomical location (trunk, arms, or legs) and measure its maximum diameter (must be 0.5 cm or less).
  2. Cleanse and prepare the surgical site using an appropriate antiseptic solution.
  3. Administer a local anesthetic (such as lidocaine with or without epinephrine) into or directly beneath the lesion to achieve regional anesthesia.
  4. Utilize a scalpel, Derma blade, or sharp surgical scissors to horizontally slice the lesion off, maintaining an angle parallel to the skin surface.
  5. Ensure the shave removal extends into the superficial dermis but specifically avoids penetrating through the full thickness of the dermis.
  6. Obtain hemostasis at the surgical site using chemical styptics (e.g., Monsel's solution, aluminum chloride) or superficial electrocautery.
  7. Apply an appropriate sterile dressing, antibiotic ointment, or bandage to the operative site.
  8. Place the excised tissue specimen in a specialized container with preservative and send it to a pathology laboratory for histologic examination, if indicated.

Coding Guidelines

  • Shaving of epidermal or dermal lesions includes the administration of local anesthesia and the chemical or electrocauterization of the wound. Do not report these services separately.
  • Code selection must strictly adhere to the anatomical location (trunk, arms, legs) and the size of the lesion (0.5 cm or less).
  • Measure the lesion's greatest clinical diameter before the procedure; the size of the margin is not included in the measurement for shaving codes.
  • Do not use shaving codes if the removal involves a full-thickness dermal excision. For full-thickness excisions, utilize the appropriate excision codes (11400-11446).
  • If a biopsy of a lesion is performed and followed by the shaving removal of the exact same lesion during the same operative session, only the shaving code should be reported.
  • If multiple distinct lesions are shaved during the same encounter, report a separate code for each lesion, appending modifier 59 or XU to the subsequent codes if required by the specific payer's guidelines.
  • Shaving of lesions is distinct from destruction methods (e.g., laser, cryotherapy, electrosurgery). Do not code destruction if a shave removal is the definitive procedure performed.

Associated ICD-10 Codes