0Q870ZZ
Division Upper Femur, Left to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | 8 Division |
| Body Part | 7 Upper Femur, Left |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z 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
Upper Femur, Left
Division of the left upper femur most commonly occurs as part of a proximal femoral osteotomy addressing hip deformities in children or adults, including varus or valgus derotation osteotomies for developmental dysplasia, Perthes disease, or slipped capital femoral epiphysis. The bone is cut, often through the intertrochanteric region, to reposition the femoral neck and head into better alignment with the acetabulum, improving joint congruency and load distribution, with fixation hardware applied afterward to maintain the new position. Surgeons must respect the vascular supply entering the femoral head through the retinacular vessels near the neck, since injury during the cut can lead to avascular necrosis. Precise documentation of laterality and osteotomy level is important given the range of proximal femoral procedures that share this anatomic region.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
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.