ICD-10 Coding for Ganglion Cyst(M67.40, M67.431, M67.432)
Complete ICD-10-CM coding and documentation guide for Ganglion Cyst. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ganglion Cyst
M67.4Primary Range
Ganglion
This range includes codes for ganglion cysts located in various anatomical sites, which are essential for accurate diagnosis and billing.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M67.40 | Ganglion, unspecified site | Use when the specific site of the ganglion cyst is not documented. |
|
| M67.431 | Ganglion, right wrist | Use when the ganglion cyst is located on the right wrist. |
|
| M67.432 | Ganglion, left wrist | Use when the ganglion cyst is located on the left wrist. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for ganglion cyst
Essential facts and insights about Ganglion Cyst
Primary ICD-10-CM Codes for ganglion cyst
Decision Criteria
documentation Criteria
- Lack of specific site documentation
Excludes
- Synovial cyst (M71.2)
Clinical Validation Requirements
- Clinical examination indicating a cystic mass
- Imaging studies such as ultrasound or MRI
Code-Specific Risks
- Risk of under-documentation leading to incorrect billing
Coding Notes
- Ensure to specify the site for more accurate coding.
M67.431 - Ganglion, right wrist
Use when the ganglion cyst is located on the right wrist.
Applicable To
- Ganglion cyst of right wrist
Clinical Validation Requirements
- Palpable mass at the wrist
- Ultrasound confirmation
Coding Notes
Ensure laterality is documented correctly.
M67.432 - Ganglion, left wrist
Use when the ganglion cyst is located on the left wrist.
Applicable To
- Ganglion cyst of left wrist
Clinical Validation Requirements
- Palpable mass at the wrist
- Ultrasound confirmation
Coding Notes
Ensure laterality is documented correctly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Aspiration/injection of ganglion cyst
20612Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Synovial cyst
M71.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ganglion Cyst to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M67.40.
Impact
Clinical: Leads to ambiguity in patient records., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Always document the side of the body affected.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Poor data quality and inaccurate health records.
Mitigation Strategy
Always document and code the specific site of the ganglion cyst.
Impact
Using M67.40 without specifying the site can trigger audits.
Mitigation Strategy
Ensure documentation includes specific site and laterality.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Ganglion Cyst, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ganglion Cyst
Use these documentation templates to ensure complete and accurate documentation for Ganglion Cyst. These templates include all required elements for proper coding and billing.
Aspiration of wrist ganglion cyst
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Procedure details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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