Knowing Definitions and Proper Diagnostic Codes is the Key to Understand Cysts
Published on Mon Nov 01, 1999
Ovarian cysts are a common gynecological problem, yet they remain a challenge when it comes to ICD-9-CM coding, especially when the physician does not indicate the type of cyst. This is due in part to the variety of ovarian cyststhere are more than 15 typesand the fact that one type of cyst might go by several different names. Others share the same code even though by definition they are very different from one another. Still others do not fit into any designated category, and get assigned a dump code for unspecified.
The most common forms of cysts that we encounter are serous, hemorrhagic and dermoid cysts, explains Philip Eskew, Jr., MD, medical director of Women and Infant Services at St. Vincent Hospital in Indianapolis, IN, and the past chairman for the Committee on Coding and Nomenclature, American College of Obstetricians and Gynecologists (ACOG). We also see a lot of endometrial or chocolate cysts.
When asked if correct identification and diagnosis of the cysts was a common problem, Eskew says, Many times we have to operate prior to diagnosis, because we cant tell from the ultrasound what type of cyst it is, and we cant tell whether the cyst is malignant or benign. The cystectomy reveals the type of cyst with which we are dealing.
In order to ease the process for coding of each type of cyst, we have provided a definition of the most common types of cysts, along with the proper diagnostic code for each.
Functional cysts
The most common ovarian cysts are called functional cysts, which result from a collection of fluid forming around an undeveloped egg. The fluid, called a follicle, is normally about the size of a pea. There are three types of functional cysts, and they are non-malignant:
1. All follicular cysts use diagnostic code 620.0, follicular cyst of ovary:
Follicular cyst occurs when the follicle does not shrink after release of the egg, and has soft, thin membrane walls that contain a clear fluid. All follicular cysts are non-malignant, but can cause severe pain when ruptured, which dissipates after a few days. There are several types of, or different names for follicular cysts:
Atretic follicular cyst, or cyst of the atretic follicle. An atretic follicle is one that degenerates before coming to maturity; great numbers of such atretic follicles occur in the ovary before puberty. In the sexually mature woman, several are formed each month and are generally not significant.
Graafian cyst, or cyst of the graafian follicle. A cyst of the graafian follicle or [...]
