Orthopedic Coding Alert

Question: Our surgeon removed a retinacular ganglion cyst from a patient's finger. The finger doesn't have fascia to help distinguish the different levels. Can I still report a more involved code, or must I report the closure as subcutaneous?

Illinois Subscriber

Answer: The correct code for the cyst removal is 26160 (Excision of lesion of tendon sheath or joint capsule [e.g., cyst, mucous cyst, or ganglion], hand or finger).

Note that CPT directs you to other codes for excision of a ganglion affecting the wrist or trigger digit. Special circumstance: Occasionally, the cyst might be so large that the skin is too stretched out for closure and your physician must perform an adjacent tissue transfer. In that case, you would report 14040 (Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less).