AHA Coding Clinic® for HCPCS - 2025 Issue 4; Ask the Editor

Ganglionectomy: Primary versus Recurrent

The patient has a history of a left dorsal wrist ganglion cyst aspiration performed approximately one year ago. The cyst has since recurred, and the patient now presents for excision of the left 2.5 cm dorsal ganglion cyst. An incision was made on the dorsal aspect of the wrist through the skin and subcutaneous tissue. Full-thickness skin flaps were elevated to expose the second, third and fourth extensor tendons. A portion of the joint capsule, including the cyst, was completely excised and the cyst stalk was debrided from the scapholunate ligament. The wound was closed, dressed and a splint was applied.For coding purposes, does the term “recurrent” in the code descriptor for CPT code 25112 indicate that the cyst must have been previously excised, or would a prior aspiration be considered the initial (primary) treatment, making this a recurrent excision? What is the correct CPT code for the excision of the wrist ganglion cyst? ...

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