Monday, May 9, 2022

Thyroglossal Duct Cyst

April’s edition of “In the kNOW”, discusses the topic of a thyroglossal duct cyst and its removal.

A thyroglossal duct cyst is a remnant of tissue from embryonic development.  At the point where the tongue separates into anterior and posterior segments, is a midline depression or pit identified as the foramen cecum.  From this area, the thyroid diverticulum or tubular duct descends, with the gland moving into its final position in the neck.  In circumstances where the duct fails to close, a cyst may occur.

The ICD-10-CM code for a thyroglossal duct cyst is Q89.2-congenital malformations of other endocrine glands.


Surgical removal of the cyst can be performed, but it is important to note that this procedure is not an excision or resection of the tongue.  While the cyst is connected to the tongue, it is not considered to be part of the tongue, so the body part will be neck.  Therefore, this is an excision of the neck, coded as  0WB60ZZ-Excision of neck, open approach.

Another point to consider when a thyroglossal duct cyst is removed, is that often part of the hyoid bone will be removed at the same time.  This surgical procedure is referred to as a Sistrunk procedure, where the thyroglossal duct cyst, the middle of the hyoid bone, and the tissue surrounding the tract are removed.  By removing part of the hyoid bone, there is significant reduction in the thyroglossal cyst recurrence rate.  Documentation of the hyoid excision should be explicit in the documentation, but if a Sistrunk procedure is documented without mention of the hyoid, a query may be in order.

If part of the hyoid is removed at the same time as the thyroglossal duct cyst excision, an additional code of 0NBX0ZZ-excision of hyoid bone, open approach should be assigned.

Now you are In the kNOW regarding thyroglossal duct cysts and their removal!!



About the Author 

Dianna Foley, RHIA, CHPS, CCS, CDIP  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.