Podiatry Coding & Billing Alert

Question: A patient was diagnosed with a ganglion cyst on the inside of his right ankle bone. An aspiration was performed that produced blood and not the usual yellow fluid. The lump returned within 24 hours of the aspiration. It was identified as pigmented villonodular tenosynovitis. How should the procedure and the diagnosis be coded?

New Jersey Subscriber

Answer: The correct code for ganglion of joint is 727.41 (Ganglion and cyst of synovium, tendon, and bursa; ganglion of joint). For the aspiration of the cyst, you should use 20612 (Aspiration and/or injection of ganglion cyst[s] any location). For the villonodular tenosynovitis, you should select diagnosis code 719.27 (Other and unspecified disorders of joint; villonodular synovitis involving ankle and foot).

Pigmented villonodular tenosynovitis is a disorder of the thin membrane surrounding a joint. The membrane produces a lubricating fluid that aids joint movement. The disorder can affect joints, tendon sheaths, and bursae.