Cyst Aspiration

Cyst Aspiration

A needle is placed with imaging guidance into the cyst to aspirate its contents. 

The most commonly involves cysts aspiration procedures are described below

1. Breast Cyst Aspiration

CPT 19000 - Puncture aspiration of cyst of breast 

CPT 19001 - Puncture aspiration of cyst of breast; each additional cyst (List separately in addition to code for primary procedure)

Procedure description:

The patient is appropriately prepped and anesthetized by local anesthesia, the physician inserts a sterile needle into the cyst using imaging guidance. He then withdraws the fluid from the cyst. Finally he ensures hemostasis.

If imaging guidance is performed, use 76942 (Ultrasonic guidance for needle placement,  imaging supervision and interpretation ) or 77021 (Magnetic resonance guidance for needle placement, radiological supervision and interpretation )

2. Baker's cyst aspiration 

CPT 10160 - Puncture aspiration of abscess, hematoma, bulla, or cyst 

For imaging guidance, Check 76942, 77012, 77021 

Procedure description:

The patient is appropriately prepped and anesthetized by local anesthesia, the physician inserts a sterile needle into the cyst using imaging guidance. He then withdraws the fluid from the cyst. Finally he ensures hemostasis.

3. Bone cyst aspiration

CPT 20615 - Aspiration and injection for treatment of bone cyst

Procedure description:

The patient is appropriately prepped and the area anesthetized, the physician inserts a sharp needle through the skin into the bone cyst. Using a syringe, he aspirates the bone cyst to drain it of any fluid or purulent material inside. He submits a sample to a laboratory for inspection. Finally he ensures hemostasis.

4. Liver, kidney, spleen, lung/mediastinum cyst aspiration

CPT - 49405 - Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous 

 Procedure description:

 The patient is prepped and sedated, the physician locates the fluid collection to be drained and uses imaging to guide percutaneous placement of a catheter to provide continuous drainage of that fluid collection, such as from an abscess. The service may also include catheter maintenance and eventual removal of the catheters.  

Moderate sedation is included.

Do not report CPT 49405 in conjunction with any guidance 75989, 76942, 77002, 77003, 77012, 77021.

5. Ganglion cyst aspiration

CPT  20612 - Aspiration and/or injection of ganglion cyst(s) any location 

For multiple ganglion cyst aspirations, use 20612 and append modifier 59

6. Thyroid cyst aspiration

CPT  60300 - Aspiration and/or injection, thyroid cyst 

For imaging guidance, use 76942 or 77012

7. Pancreatic pseudocyst aspiration

Use CPT 49405 - Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous

8. Renal cyst Aspiration

CPT 50390 - Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous 

For radiological supervision and interpretation, see 74425, 74470, 76942, 77002, 77012, 77021

CPT 74425 - Urography, antegrade (pyelostogram, nephrostogram, loopogram), radiological supervision and interpretation

CPT 74470 - Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation 

For Fine Needle Aspiration use 10022 with imaging guidance and use 10021 for no imaging guidance.