Knee Mass ?

codedog

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NEW ORLEANS
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Mass but does not appear knee joint , so would this still be considered 27327 or 23747? Path report came back as a ruptured ganglion or synovial cyst . Reason why Iam asking is dx code 727.40-synovial cyst does not match with 23727?,
PREOPERATIVE DIAGNOSIS: Left knee mass.

POSTOPERATIVE DIAGNOSIS: Left knee mass.

PROCEDURE PERFORMED: Excision and biopsy of left knee mass.

ANESTHESIA: MAC.

ESTIMATED BLOOD LOSS: Minimal.

CLINICAL HISTORY: This is a a mass in the lateral aspect of left knee, which on exam does not appear to be a part of her knee joint.

PROCEDURE IN DETAIL: The patient was brought into the operating room and placed on the operating room table in a supine position. Her left knee was prepped and draped in a sterile fashion. 10 cc of 1% lidocaine with epinephrine were injected for local anesthesia. A transverse incision was made directly over the mass. Using electrocautery and sharp dissection, the mass was dissected free of the surrounding tissue. It appeared to be consistent with a ganglion cyst. It was dissected up to its neck and it was transected at the neck, the neck was ligated with a 3-0 Vicryl figure-of-eight suture. The wound was irrigated with normal saline and inspected and found to be hemostatic. The mass had been excised with grossly negative margins. The subcutaneous tissue was closed with interrupted 3-0 Vicryl suture and interrupted 3-0 nylon was used to close the skin. Sterile dressing was applied. The patient tolerated the procedure well.
 
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Muncie, IN
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Since the path report is unclear as to whether it is synovial cyst or ganglion, I would go with what the op report states.
727.43 with CPT 27347
If it is decided that it is in fact a synovial cyst, I would code:
727.51 (popliteal space, does not state in the joint) with CPT 27345
But, that is just my opinion.
~Melissa, CPC :)
 
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