0QB90ZZ
Excision Femoral Shaft, 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 | B Excision |
| Body Part | 9 Femoral Shaft, Left |
| 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 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
Femoral Shaft, Left
The left femoral shaft is the straight, cylindrical diaphyseal segment of the thighbone lying between the hip and knee, built of thick cortical bone to withstand axial loading during standing and gait. Excision of a portion of this bone is typically undertaken to remove infected or dead cortex in osteomyelitis, sample tissue from a bone lesion, or excise a benign growth such as an osteochondroma arising from the shaft. Because removing shaft cortex can compromise the femur's load-bearing capacity, surgeons weigh the size and location of the excised segment carefully and may plan for stabilization afterward. The procedure is generally performed through a lateral surgical approach, and documentation should clarify whether the excision was limited to cortical bone or extended into the medullary cavity.
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
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.