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Intralesional Steroid Injection Consent Form - Twin Peaks 2025

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The document is an Intralesional Steroid Injection Consent Form from Twin Peaks Dermatology, PC. It outlines the authorization for injecting a steroid into the skin, lists alternatives and risks of the procedure, emphasizes the importance of understanding the form before signing, and includes sections for patient's signature, witness, and provider's declaration.

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What are the indications for intralesional steroid injections?

An intralesional steroid injection may be indicated for the following skin conditions: Alopecia areata. Discoid lupus erythematosus. Keloid/hypertrophic scar. Granuloma annulare. Other granulomatous disorders such as cutaneous sarcoidosis or granuloma faciale. Hypertrophic lichen planus.

What steroids are used for intralesional injections?

Intralesional steroid injections (ILS), mainly triamcinolone acetonide, are standard treatment for many skin diseases including keloids, alopecia areata, and circumscribed plaques of dermatitis. [1] Though, the treatment is generally safe; side effects are known to happen including local hypo pigmentation and atrophy.

What is the procedure code for intralesional steroid injection?

You report CPT code 11900 (Injection, intralesional; up to and including 7 lesions) when your physician injects steroids in seven []

What is the CPT code for intralesional steroid injection?

Injection CPT Code Options CPT CodeDescriptionGlobal Period 11900 Injection, intralesional; up to and including seven lesions 0 days 64612 Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (eg, for blepharospams, hemifacial spasm) 10 days10 more rows

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