0UB78ZZ
Excision Fallopian Tubes, Bilateral to No Qualifier with No Device, Via Natural or Artificial Opening Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | B Excision |
| Body Part | 7 Fallopian Tubes, Bilateral |
| Approach | 8 Via Natural or Artificial Opening Endoscopic |
| 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 in the female reproductive system involve cutting out a portion of an organ or structure - such as a wedge of ovarian tissue, part of a fallopian tube, a myomectomy removing a fibroid from the uterine wall, or a partial vulvectomy - while leaving the remainder of that body part in place. These procedures are used both to treat disease and to obtain tissue for diagnosis, so the same root operation covers everything from a small cervical biopsy to removal of an ectopic pregnancy mass confined to a tube.
Patients encounter excision most often for suspicious lesions that need pathological evaluation, benign growths like fibroids or ovarian cysts that are causing pain or bleeding, or endometriosis implants that need to be removed without sacrificing the organ they're attached to. Because only part of the structure is taken, the remaining organ typically continues to function, which distinguishes the intent behind excision from operations that remove an entire body part.
The surgical approach varies widely - some excisions are done through a hysteroscope or laparoscope with small ports, others through an open abdominal incision - but the defining feature is always partial removal without replacing the tissue taken out.
Anatomy & Axis Detail
Fallopian Tubes, Bilateral
Bilateral removal of both fallopian tubes is increasingly performed not only for tubal disease such as bilateral hydrosalpinx or ectopic pregnancy but as a stand-alone risk-reducing procedure, given mounting evidence that the tubal fimbriae are the site of origin for most high-grade serous ovarian and peritoneal cancers, making opportunistic bilateral salpingectomy a common addition during other pelvic surgeries even when tubal disease is not the primary indication. Unlike bilateral oophorectomy, this procedure preserves ovarian hormonal function since the ovaries remain intact, making it an attractive option for patients seeking cancer risk reduction without inducing surgical menopause. The operation also serves as a permanent sterilization method, and surgeons must carefully separate the mesosalpinx from the ovarian blood supply on both sides to avoid compromising ovarian perfusion during removal.
Approach: Via Natural or Artificial Opening Endoscopic
Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.
Coding & Documentation
A coder should look for operative language describing removal of "a portion," "a segment," or a discrete lesion, mass, or margin of tissue, with the rest of the organ left intact. Pathology reports confirming a specimen of a specific size or the surgeon's note describing wedge resection, partial salpingectomy, or myomectomy all support Excision. The approach value (open, percutaneous endoscopic, or via natural orifice) should match the documented technique precisely, since laparoscopic and open myomectomies carry different codes despite the same root operation.
The most common assignment error is confusing Excision with Resection when an entire organ, tube, or ovary is actually removed - documentation stating "total" or "complete" removal points to Resection instead. Coders also sometimes default to Excision for biopsies without confirming the qualifier value that identifies a diagnostic procedure, and miss cases where multiple structures were excised in the same operative session, each requiring a separate code.