Orthopedic Coding Alert

Reader Questions:

Avoid Ganglion Code for Baker's Cyst

Question: Which CPT code applies to aspiration of a Baker's cyst? Connecticut Subscriber Answer: Assuming this was a puncture aspiration, your best bet is 20610 (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]). Watch out: Many coders mistakenly choose 20612 (Aspiration and/or injection of ganglion cyst[s] any location). But a ganglion cyst and Baker's cyst are not the same, so this code choice is not accurate. A Baker's cyst is a joint capsule herniation from excessive synovial fluid rather than a true cyst. The proper ICD-9 code for a Baker's cyst is 727.51 (Synovial cyst of popliteal space). You would report a ganglion cyst with 727.4x (Ganglion and cyst of synovium, tendon and bursa). ICD-9 includes a note with 727.4x: Excludes that of popliteal space (727.51).
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