Look for Anatomic Details Before Choosing Cyst Code
Question: When a patient reports to the emergency department (ED) with a ganglion cyst, what is the correct ICD-10-CM code for the patient? Texas Subscriber Answer: You’re going to start in the M67.4- (Ganglion) code set, but you’ll need more information to get a more specific diagnosis for the patient. Do this: Go back and check the notes for the anatomic location and laterality of the cyst. The M67.4- code set contains codes for ganglion cysts of the shoulder, elbow, wrist, hand, hip, knee, and ankle and foot; the 5th character of your ICD-10-CM code will represent anatomical location. If you have this information, use it to choose the 5th character. Then, report a 6th character to indicate the laterality of the cyst. You can represent the right side (6th character “1”), left side (6th character “2”), or unspecified side (6th character “9”). Remember: All of the above advice is for ganglion diagnoses that include a specific anatomic location and laterality. If you don’t have that information, you’re going to have to report M67.40 (Ganglion, unspecified site). If the ganglion is in an anatomic area that isn’t represented in M67.4-, opt for M67.48 (Ganglion, other site). Finally, if the patient has cysts in multiple anatomic locations, choose M67.49 (Ganglion, multiple sites). Chris Boucher, MS, CPC, Senior Development Editor, AAPC
