# Mucous & Retinacular Cyst w/Osteophyte



## LIVE2CODE (Aug 7, 2017)

I then made a 1.5 cm mid-lateral incision over the right finger radial aspect between the DIP and PIP joint.  I dissected down to find a retinacular cyst.  I was able to remove this in its entirety, careful to protect the neurovascular structures.

I then turned my attention to the mucous cyst.  I made a 1.5 cm curved longitudinal incision dorsally over the distal interphalangeal joint.  I dissected down and found a mucous cyst extruding eccentrically from the dorsal aspect of the distal interphalangeal joint.  I was able to dissect the cyst all the way out to the dorsal osteophyte.  I opened up the extensor mechanism longitudinally to expose the dorsal osteophyte, which I then removed sharply with a rongeur.  I completely removed the dorsal osteophyte as well as the cyst.

26210 for Mucous cyst & Osteophyte 
26160 for Retinacular cyst

any help would be appreciated


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## AlanPechacek (Aug 9, 2017)

The "Retinacular Cyst" is essentially the same thing as a Ganglion Cyst, so the 26160 would be correct.  The "Mucous Cyst" is a degenerative cyst very similar to a Ganglion Cyst except that it derives/originates from the arthritic DIP Joint.  Removing it, along with the dorsal exostosis of the distal phalanx (a bonus to the patient), is essentially the same procedure, 26160.  Since neither the Mucous Cyst nor the Exostosis are a "Bone Cyst" or a "Benign Tumor" of the Distal Phalanx, their removal would not qualify for/as 26210.  Basically he did 26160 twice.  You could/should add one of the Modifier 59 variants, or Modifier 51, to one of the two codes to indicate that two separate procedures were done, even though they were the same.

I hope this helps.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com


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## fish4codes (Mar 9, 2018)

I ran across this thread as I was, once again, refreshing myself on the whole mucous cyst code, etc..  However, my question, Dr. P - would 26236 not be appropriate for this procedure as the osteophyte was removed from the DIP joint (26160 being the code 2 pair with 26236 so not allowable)?
Respectfully,
Cindy


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