2nd request please ganglion exicision?

BFAITHFUL

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our doc wants to bill exicision of ganglion cyst using cpt 26160 but according to op report it just doesn't look like he's dictating an excision of a cyst, it looks like an excision of a spur?


Patient is a femal who has had a ganglion cyst develop on the left middle finger that has progressively bcome infected. There is need for removal.

Surgery:
The patient had the area managed by making an incision overlying the DIP joint. With this done, the patient had then the arthritic spur immediately encountered. The spur itself was removed, and the the patient had the area of the skin involvement also resected. Wound itself was then irrigated with betadine, and skin flaps were then meticulously capted with 5-0 chromic placed in deep tissues.

Path report: fibrotendinous tissue with focal myxoid degnerative changes., hyperkertotic skin
 

PLAIDMAN

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our doc wants to bill exicision of ganglion cyst using cpt 26160 but according to op report it just doesn't look like he's dictating an excision of a cyst, it looks like an excision of a spur?


Patient is a femal who has had a ganglion cyst develop on the left middle finger that has progressively bcome infected. There is need for removal.

Surgery:
The patient had the area managed by making an incision overlying the DIP joint. With this done, the patient had then the arthritic spur immediately encountered. The spur itself was removed, and the the patient had the area of the skin involvement also resected. Wound itself was then irrigated with betadine, and skin flaps were then meticulously capted with 5-0 chromic placed in deep tissues.

Path report: fibrotendinous tissue with focal myxoid degnerative changes., hyperkertotic skin
According to path report it does look like a cyst, not sure if "ganglion" but myxoid means mucus and my medical dictionary tells me, for a myxoid cyst see ganglion. I think he is confusing by calling it a spur.

I would say yes it is a ganglion excision, but with him calling it a spur, you might end up having a hard time getting it paid, In my experience payors dont have dictionaries.
 
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