Orthopedic Coding Alert

Question: Which ICD-9 codes should we report for a patient who had surgery addressing carpal tunnel syndrome and a ganglion cyst?

Rhode Island Subscriber

Answer: You should report 354.0 (Carpal tunnel syndrome) and 727.43 (Ganglion, unspecified).

Example: The surgeon performs a primary wrist ganglion excision (25111, Excision of ganglion, wrist [dorsal or volar]; primary) and then performs carpal tunnel release (64721, Neuroplasty and/or transposition; median nerve at carpal tunnel). You should link 64721 to 354.0 and 25111 to 727.43.

Don't forget: You should append modifier 51 (Multiple procedures) to 25111 for payers that require this modifier. You may use modifier 51 when the same physician performs more than one procedure during the same session, and the second service is not a component of the first

Helpful: If the surgeon had documented that the cyst emanated from the joint, you would report 727.41 (Ganglion of joint) instead.