ICD-10-PCS Billable Code

0Q843ZZ

Division Acetabulum, Right to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
Operation8 Division
Body Part4 Acetabulum, Right
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Cutting into a body part, without draining fluids and/or gases from the body part, in order to separate or transect a body part

Procedure Overview

Division procedures in the lower bones involve cutting into a bone to separate or transect it, without draining any fluid or gas in the process. The clearest example is an osteotomy performed to realign a deformed limb - cutting through the femur, tibia, or another lower bone so the two segments can be repositioned into better alignment, often before fixation hardware holds the new position in place.

These procedures are used for correcting angular deformities, lengthening or shortening a limb segment, or releasing a bony bridge such as a growth plate bar that is restricting normal bone growth in a child.

Anatomy & Axis Detail

Acetabulum, Right

The right acetabulum, the cup-shaped socket that articulates with the femoral head, is divided during periacetabular osteotomy procedures performed to correct hip dysplasia or improve femoral head coverage in young adults with a preserved joint. The surgeon cuts through the surrounding bone in a curved pattern that frees the acetabular fragment while keeping it attached to its blood supply, then reorients it to a more anatomic position, a technique often called the Bernese or Ganz osteotomy. Because the acetabulum sits adjacent to the hip joint capsule, sciatic nerve, and pelvic vasculature, this is a technically demanding procedure requiring careful fluoroscopic or navigated guidance, and the division is distinct from the reduction and fixation steps that follow to stabilize the repositioned fragment.

Approach: Percutaneous

Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.

Coding & Documentation

Coders should confirm the note describes cutting the bone through its full thickness to separate it into distinct segments, distinguishing it from a partial cut or notch. If the surgeon also placed fixation hardware to hold the newly divided bone in position, that stabilization step is coded separately as Insertion in addition to the Division.

A frequent mistake is coding Division when the intent and outcome was actually a fusion - if the bone segments were subsequently joined together, Fusion may be the more accurate root operation for that portion of the procedure. Coders should also avoid defaulting to Division for procedures where fluid was drained as part of the cut, since draining changes the root operation to Drainage.

Commonly Confused With

FusionFusion (0QG) is the procedure most often confused with Division, since an osteotomy is sometimes performed as a preliminary step before fusing bone segments together - the cutting is Division, but joining the segments so they grow together is Fusion.
DrainageDrainage (0Q9) differs because it involves letting fluids or gases out of a bone, which Division specifically excludes.
ExcisionExcision is distinct because it removes a portion of bone rather than simply separating it into two connected or repositioned pieces.