ICD Code M67.461

ICD code M67.461 is used to identify a ganglion cyst located in the right knee. A ganglion cyst is a noncancerous lump that often develops along the tendons or joints of your wrists or hands, but it can also occur in other areas such as the knee. This specific code helps healthcare providers accurately document and communicate the diagnosis of a ganglion cyst in the right knee, ensuring proper treatment and billing processes within the healthcare revenue cycle.

When determining the appropriate use of the ICD code for a ganglion at the right knee, consider the following diagnostic criteria and symptoms:

1. Presence of a palpable mass: A noticeable lump or swelling in the area around the right knee.

2. Pain or discomfort: Patient reports localized pain or discomfort in the knee region, particularly when the mass is palpated or during movement.

3. Joint stiffness: The patient may experience stiffness in the knee joint, especially after periods of inactivity.

4. Limited range of motion: Difficulty in fully extending or flexing the knee due to the presence of the ganglion.

5. Symptoms of nerve compression: Signs of nerve involvement, such as tingling, numbness, or weakness in the leg or foot.

6. History of joint injury: Previous trauma or injury to the knee that may have contributed to the formation of the ganglion.

7. Imaging findings: Confirmation of the ganglion through imaging studies, such as ultrasound or MRI, showing a cystic structure adjacent to the knee joint.

8. Absence of infection: No signs of infection, such as redness, warmth, or fever, that would suggest an alternative diagnosis.

9. Duration of symptoms: Symptoms persisting for a significant period, typically several weeks to months, without resolution.

10. Exclusion of other conditions: Ruling out other potential causes of knee pain or swelling, such as bursitis, arthritis, or tumors.

These criteria can help healthcare providers determine the necessity of using the specific ICD code for documentation and billing purposes.

For the ICD code M67.461, which pertains to a ganglion in the right knee, the relevant CPT codes that may be applicable for treatment include:

1. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee joint, subacromial bursa); without ultrasound guidance.

2. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee joint, subacromial bursa); with ultrasound guidance.

3. 26160 - Excision of lesion of tendon sheath or joint capsule (e.g., cyst, mucous cyst, or ganglion), hand or finger.

4. 29870 - Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure).

5. 29871 - Arthroscopy, knee, surgical; for infection, lavage, and drainage.

6. 29875 - Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection) (separate procedure).

7. 29876 - Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral).

These CPT codes are commonly associated with procedures that may be performed to address conditions related to a ganglion in the knee. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario. Always ensure accurate coding by reviewing the latest coding guidelines and payer-specific requirements.

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