0LB74ZZ
Excision Hand Tendon, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | B Excision |
| Body Part | 7 Hand Tendon, Right |
| Approach | 4 Percutaneous 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
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
Hand Tendon, Right
Hand tendon excision on the right involves the flexor or extensor tendons running through the palm and digits, frequently targeted when a nodule, cyst-associated thickening, or chronically inflamed segment interferes with finger gliding or causes triggering. Because hand tendons are thin, closely spaced, and essential for fine motor function, surgeons excise only the diseased portion, working carefully to avoid destabilizing the pulley system that keeps tendons apposed to the underlying bone. This procedure is distinct from trigger finger release, which addresses the sheath rather than the tendon itself, so documentation should clarify that tendon tissue, not sheath, was removed. Postoperative hand function depends heavily on how much of the excised tendon's cross-section was affected.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
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.