02B90ZZ
Excision Chordae Tendineae to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 2 Heart and Great Vessels |
| Operation | B Excision |
| Body Part | 9 Chordae Tendineae |
| Approach | 0 Open |
| 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 procedures cut out and remove a portion of a heart structure or great vessel without replacing it with anything else. Only part of the body part is taken, distinguishing it from more extensive removal of an entire structure. This might involve removing a segment of diseased tissue, a small mass, or an abnormal growth from within a heart chamber or vessel wall.
Surgeons perform these procedures for reasons ranging from removing a tumor such as a myxoma, to taking a tissue sample for biopsy, to trimming away scarred or damaged tissue that is affecting heart function. Because only a portion of the structure is removed, the underlying body part continues to exist afterward, just in an altered or reduced form.
Anatomy & Axis Detail
Chordae Tendineae
The chordae tendineae are fibrous cords connecting the papillary muscles to the mitral and tricuspid valve leaflets, preventing leaflet prolapse into the atrium during ventricular contraction. Excision of chordal tissue is a component of valve repair for conditions such as myxomatous degeneration, ruptured chordae following endocarditis, or ischemic changes, where elongated, redundant, or ruptured cords are cut away to correct prolapse or restore proper leaflet coaptation. Because chordae are frequently addressed alongside leaflet resection, annuloplasty, or chordal replacement with artificial material, the operative note must specify that native chordal tissue was excised as a distinct step rather than simply repaired or reinforced. Precise identification of which valve's chordae were involved is necessary since the procedure is coded separately from work on the leaflets or annulus themselves.
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 need operative documentation confirming that only part of the body part was removed and that nothing was excised in its entirety, since removal of an entire body part changes the root operation to Resection. Biopsies are a frequent source of confusion: when a sample is taken purely for diagnostic purposes it is still coded as Excision, and the qualifier for diagnostic intent should be applied when documentation supports it. A common error is coding Excision when the surgeon actually removed the entire structure, such as an entire appendage or vessel segment between two anatomic landmarks, which instead requires Resection; another is missing that tissue removed as an inherent part of a more extensive procedure, like debris cleared during a bypass, is not separately coded.