How To Use CPT Code 20612

CPT code 20612 describes the aspiration and/or injection of ganglion cyst(s) in any location. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20612?

CPT 20612 is used to describe the aspiration and/or injection of ganglion cyst(s) in any location. A ganglion cyst is an abnormal fluid-filled mass that typically arises from a tendon or joint, commonly occurring in the hand or wrist but can also occur in the foot or ankle. Treatment for a ganglion cyst is not always necessary unless it causes pain or restricts movement. In cases where treatment is required, aspiration or injection may be performed to remove the fluid or destroy the cyst.

2. Official Description

The official description of CPT code 20612 is: ‘Aspiration and/or injection of ganglion cyst(s) any location.’

3. Procedure

The procedure for CPT 20612 involves the following steps:

1. The patient is appropriately prepped, and the area to be treated is anesthetized.
2. The healthcare provider inserts a sharp needle through the external skin surface and into the ganglion cyst.
3. Using a syringe, the provider aspirates the cyst to drain the fluid inside. In some cases, a sample may be sent to a laboratory for inspection.
4. If necessary, the provider may also inject a destructive or anti-inflammatory substance into the ganglion cyst.

4. Qualifying circumstances

CPT 20612 is used for the aspiration and/or injection of ganglion cyst(s) in any location. It is typically performed when the ganglion cyst causes pain or restricts movement. The procedure can be performed by a qualified healthcare provider who is trained in performing aspirations and injections. It is important to note that if multiple ganglion cyst aspirations/injections are performed, modifier 59 should be appended to the code.

5. When to use CPT code 20612

CPT code 20612 should be used when performing the aspiration and/or injection of ganglion cyst(s) in any location. It is appropriate to use this code when the ganglion cyst causes pain or restricts movement and requires treatment. However, it is important to review the specific documentation and guidelines provided by the payer to ensure accurate coding and billing.

6. Documentation requirements

To support a claim for CPT code 20612, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for aspiration and/or injection of ganglion cyst(s)
• Location of the ganglion cyst(s)
• Procedure performed (aspiration, injection, or both)
• Details of the procedure, including the use of any destructive or anti-inflammatory substances
• Date of the procedure
• Any complications or adverse reactions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 20612, ensure that the procedure performed is the aspiration and/or injection of ganglion cyst(s) in any location. If multiple ganglion cyst aspirations/injections are performed, modifier 59 should be appended to the code. It is important to review the specific billing guidelines provided by the payer to ensure accurate coding and billing.

8. Historical information

CPT code 20612 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Similar codes to CPT 20612

There are several similar codes to CPT 20612 that are used for procedures on the musculoskeletal system. Some examples include:

• CPT 20550: Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar “fascia”)
• CPT 20600: Arthrocentesis, aspiration and/or injection; small joint or bursa (e.g., fingers, toes)
• CPT 20605: Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)
• CPT 20610: Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa)
• CPT 20615: Aspiration and/or injection of bone cyst

9. Examples

1. A patient presents with a ganglion cyst on their wrist that causes pain and restricts movement. The healthcare provider performs an aspiration to drain the fluid from the cyst.
2. A patient has a ganglion cyst on their foot that is causing discomfort. The healthcare provider performs an injection with a destructive substance to destroy the cyst.
3. A patient has multiple ganglion cysts in different locations, and the healthcare provider performs aspirations and injections on each cyst during the same visit, appending modifier 59 to indicate separate procedures.
4. A patient has a ganglion cyst on their hand that has recurred after a previous aspiration. The healthcare provider performs another aspiration and sends a sample of the fluid for laboratory inspection.
5. A patient has a ganglion cyst on their ankle that is causing pain during movement. The healthcare provider performs an injection with an anti-inflammatory substance to reduce inflammation and alleviate symptoms.
6. A patient has a ganglion cyst on their finger that is causing discomfort and affecting their ability to grip objects. The healthcare provider performs an aspiration to relieve the pressure and improve hand function.
7. A patient has a ganglion cyst on their knee that is causing pain and swelling. The healthcare provider performs an injection with a destructive substance to shrink and destroy the cyst.
8. A patient has a ganglion cyst on their shoulder that is causing pain and limited range of motion. The healthcare provider performs an aspiration to remove the fluid and alleviate symptoms.
9. A patient has a ganglion cyst on their wrist that has recurred multiple times. The healthcare provider performs an injection with a combination of a destructive and anti-inflammatory substance to destroy the cyst and reduce inflammation.