ICD-10-PCS Billable Code

0LBW0ZZ

Excision Foot Tendon, Left to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemL Tendons
OperationB Excision
Body PartW Foot Tendon, Left
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Cutting out or off, without replacement, a portion of a body part

Procedure Overview

Tendon excision procedures cut out and remove a portion of a tendon without replacing it, typically to address a tumor, a chronically degenerated segment, a painful nodule, or scar tissue that is limiting motion. A well-known example is excision of a trigger finger nodule or a portion of tendon affected by tenosynovitis that has not responded to more conservative treatment, as well as biopsy of a suspicious mass for diagnostic purposes.

Because only part of the tendon is taken and the remainder is left in place, the surgeon must weigh how much tissue can be safely removed without compromising the tendon's mechanical function. In many cases the excised tissue is sent to pathology, which both confirms the diagnosis and distinguishes this procedure from techniques that simply destroy tissue in place.

Anatomy & Axis Detail

Foot Tendon, Left

The left foot tendon group, including the extensor and flexor tendons of the toes and other intrinsic tendinous structures, supports toe flexion, extension, and forefoot balance during weight-bearing activity. Excision is performed to remove degenerated or inflamed tendon segments, commonly for chronic tenosynovitis, a painful nodule, or a diagnostic biopsy of a soft tissue mass. Diabetic patients and those with rheumatoid disease are frequently affected by tendon changes in the foot that necessitate this procedure. Given the tightly packed anatomy of the forefoot, where tendons run close to metatarsal bones, joints, and digital nerves, surgeons take a targeted approach to remove only the diseased segment. Accurate identification of the specific tendon and its dorsal or plantar surface is necessary for precise documentation.

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

A code from this family is appropriate when the operative note documents cutting out and removing a defined portion of tendon tissue, with the remaining tendon left intact and nothing reconstructed at the same time. Look for language describing a specimen sent to pathology, the anatomic tendon and location, and confirmation that the entire tendon was not removed, which would instead point toward Resection.

A common mistake is coding Excision when the whole tendon was actually removed, since ICD-10-PCS distinguishes cutting out "all or a portion" only when characterizing the two operations differently, that is, Excision for a portion and Resection for all of a body part. Coders also sometimes overlook a concurrent repair, such as a tendon graft or suture closure performed after excision, which requires a separate code if it meaningfully restores structure beyond simple wound closure.

Commonly Confused With

ResectionResection is the closest neighbor and the distinction hinges entirely on whether the entire tendon was removed versus only a segment.
ExtirpationExtirpation can be confused with Excision when a mass being removed is actually loose or abnormal solid matter, like a foreign body or a discrete calcified nodule not integrated into the tendon structure, rather than a piece of the tendon itself.
DestructionDestruction differs because it eradicates tissue without physically removing it from the body, so no specimen exists for pathology, which is a helpful clue when the documentation is otherwise ambiguous.