Vermilionectomy
Vermilionectomy is a surgical removal of the vermilion border. It is sometimes performed to treat carcinoma of the lip. The vermilion border is the normally sharp demarcation between the lip (red colored) and the adjacent normal skin.
It represents the change in the epidermis from highly keratinized external skin to less keratinized internal skin. It has no sebaceous glands, sweat glands, or hair.
The vermilion border is important in dentistry and oral pathology as a marker to detect disease, such as in actinic cheilitis.
There are two reasons for the border being red:
- The epithelium is thin.
- This epithelium containseleidin which is transparent and the blood vessels are near the surface of the papillary layer, revealing the “red blood cell” color. At the angles of the mouth, there are sebaceous glands, without hair follicles, which are called Fordyce’s spots.
Coding of Vermilionectomy
The CPT code for Vermilionectomy is 40500 Vermilionectomy (lip shave), with mucosal advancement) is the shaving or excision of the vermilion border of the lip.
This code also includes the repair of the excisional area by mucosal advancement. If more tissue is excised or removed from the lip area, codes must be chosen from code range 40510-40530. Choose wedge resections or full-thickness excisional codes based on the tissue excised and the reconstruction performed to correct the defect. These reconstructions are built into the code; do not report them separately with any other repair codes. Do not additionally report codes from the Integumentary System section, when reporting 40510-40527.