0QBS3ZZ
Excision Coccyx to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | B Excision |
| Body Part | S Coccyx |
| 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 procedures on the lower bones remove a portion of a bone in the pelvis, hip, leg, ankle, or foot without replacing what's taken out. Surgeons perform these when a piece of bone needs to come out but the rest of the bone can stay in place - trimming a bone spur pressing on a nerve, taking a wedge sample from a suspicious lesion to send for biopsy, or shaving down a prominent area that's causing pain or skin breakdown.
Because only part of the bone is involved, the surrounding structure typically remains functional. Recovery often centers on protecting the area while it heals rather than rebuilding lost function, though larger excisions near a joint may need a period of limited weight-bearing.
Anatomy & Axis Detail
Coccyx
The coccyx, or tailbone, is the small triangular bone at the base of the spine formed by three to five fused or partially fused vertebral segments, serving as an attachment point for pelvic floor muscles and ligaments. Excision of a portion of it, known clinically as a partial coccygectomy, is typically performed for chronic coccydynia that has not responded to conservative treatment, or for a pilonidal disease process extending toward the bone, or for a sacrococcygeal teratoma requiring removal of adjacent bony tissue in a pediatric patient. Because the coccyx lies in close proximity to the rectum and the extensive presacral venous plexus, the procedure carries meaningful risk of bleeding and wound complications, and documentation should clarify whether the excision is partial, since removal of the entire structure would instead be coded as 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
Assign an excision code when the operative note describes cutting out a discrete portion of a lower bone - an exostosis, an osteophyte, a bone biopsy specimen, or margins around a tumor - without inserting a device or graft to replace the missing bone. The note should specify the bone and the general region (e.g., femoral neck, calcaneus) since Lower Bones is subdivided by specific bone. A common assignment error is coding excision when the surgeon actually removed the entire bone or a full bony process, which is resection; another is missing that a biopsy taken via excisional technique still codes as excision even though it's diagnostic rather than therapeutic.