0PB33ZZ
Excision Cervical Vertebra to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | P Upper Bones |
| Operation | B Excision |
| Body Part | 3 Cervical Vertebra |
| Approach | 3 Percutaneous |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, a portion of a body part
Procedure Overview
Excision covers cutting out a portion of an upper bone without replacing it, most often to obtain a tissue sample for diagnosis or to remove a tumor, cyst, or damaged segment while leaving the surrounding bone intact. Rib excisions are performed for suspected malignancy or to gain surgical access to the chest, clavicle and scapula excisions address tumors or nonunion fragments, and small excisional biopsies are done on the humerus, forearm bones, or hand bones when imaging shows an indeterminate lesion.
Because only a portion of the bone is taken and the rest of the structure remains, this differs from removing an entire bone or joint segment. The excised tissue is typically sent to pathology, and the remaining bone may need grafting or fixation depending on how much structural support was lost.
Anatomy & Axis Detail
Cervical Vertebra
Excision of a cervical vertebra removes a portion of one of the seven neck vertebrae without taking the entire bone, commonly performed to biopsy a suspicious lesion, debride an infected disc space, or resect a small tumor encroaching on the spinal canal. The cervical spine's tight relationship to the spinal cord, vertebral arteries, and nerve roots makes even a partial excision technically demanding, and documentation should specify whether the procedure targeted the vertebral body, lamina, or another discrete structure, since the qualifier and approach reflect that anatomy. Surgeons often use an anterior cervical approach for vertebral body work or a posterior approach for the lamina, and the operative note should distinguish cutting out a portion of bone from the more extensive removal captured by resection.
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 need documentation confirming that a portion, not the entirety, of the named bone was cut out, along with the specific bone and, where relevant, whether the procedure was diagnostic. A biopsy that removes only a small sample for pathology still falls under Excision, with a qualifier indicating diagnostic intent.
The most frequent error is selecting Excision when an entire bone or a whole anatomical segment such as the whole clavicle was removed, which instead falls under Resection. Another common issue is failing to code bone grafting or fixation performed immediately afterward as separate procedures when the operative note describes them as distinct steps.