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Thread: Synovial Cyst rupture

  1. #1
    Join Date
    Apr 2007
    Casper, Wyoming

    Default Synovial Cyst rupture

    AAPC: Back to School
    We need advice or confirmation on this: We are thinking that 77002(fluoro), 62268(percutaneous aspiration spinal cord cyst) as the procedure codes.

    1. Fluoroscopic-guided synovial
    cyst rupture.

    TECHNIQUE: After obtaining informed, written consent,
    the back is prepped,
    draped and anesthetized in sterile fashion.
    Under fluoroscopic guidance,
    local anesthesia is applied to the
    medial branch nerves above and below the
    level of the joint. Under
    fluoroscopic guidance, a 22g needle is advanced
    into the joint with
    aspiration of approximately 1 mL of synovial fluid.
    Following this,
    instillation of contrast is performed, determining needle
    location to
    be within the joint. Subsequently, approximately 2-3 mL of

    preservative-free 1% lidocaine are instilled into the joint: the
    solution was
    allowed to dwell for 5 minutes. The joint was
    re-aspirated. Using
    non-bacteriostatic preservative-free saline, the
    joint and cyst are injected
    with resistance and then loss of
    resistance, indicating cyst rupture.
    Following this, 1 mL of
    preservative free Celestone was slowly injected into
    the joint. A
    small amount of contrast was again instilled into the joint.
    needle was removed. The patient tolerated the procedure well and left
    department in unchanged condition.

    FINDINGS: Images demonstrate
    the needles at the positions for L5 and S1
    medial branch blocks, as
    well as within the appropriate facet joint.
    Opacification of the
    synovial cyst is seen during contrast instillation.
    Contrast extends
    beyond the original boundary of the cyst on the infusion of
    after cyst rupture, confirming rupture of the cyst.

    Successful left L5-S1 synovial cyst rupture and instillation of

    preservative free Celestone, as outlined above.

    Any input is greatly appreciated.

  2. #2

    Default coder

    Did you ever get a reply on this question? Because I have the same question..

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