12/16/2016

Proper Coding for Ganglion Cyst and Biopsy

What is the proper procedure code for the aspiration of a ganglion cyst? Do you bill for a biopsy as well? If so what is that proper code?

The correct CPT code for the aspiration of a ganglion cyst is 20612. The aspiration technique is identical to the fine needle aspiration for biopsy. If you are aspirating the cyst, you are already removing fluid that can be sent for analysis. The usual content of a ganglion consists of a gelatinous, clear or sometimes slightly golden material which can also be manually expressed once the cyst is punctured. This material is sent to pathology to help confirm the diagnosis.  If the pathology report is not able to confirm the diagnosis, the lesion should be surgically excised.

20612: Aspiration and/or injection of ganglion cyst(s) any location. The physician aspirates and/or injects a ganglion cyst. After administering a local anesthetic, the physician inserts a needle through the skin and into the ganglion cyst. A ganglion cyst is a benign mass consisting of a thin capsule containing clear, mucinous fluid arising from an aponeurosis or tendon sheath, such as on the back of the wrist or foot. A fluid sample may be withdrawn from the cyst or a medicinal substance may be injected for therapy. The needle is withdrawn and pressure is applied to stop any bleeding.