0LBQ3ZZ
Excision Knee Tendon, Right to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | B Excision |
| Body Part | Q Knee Tendon, Right |
| 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
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
Knee Tendon, Right
The right knee tendon group includes the patellar tendon, popliteus tendon, and the distal insertions of the hamstring and quadriceps that cross the joint. Excision of tissue from these structures is typically indicated for chronic patellar tendinopathy, a symptomatic nodule such as in jumper's knee, or removal of a mass for diagnostic purposes. The patellar tendon's central role in knee extension makes any excision here significant, as surgeons aim to remove only degenerated fibers while preserving the tendon's load-bearing continuity. The popliteus tendon, tucked within the posterolateral corner of the joint, is a less common but distinct target requiring careful arthroscopic or open exposure. Precise identification of the tendon involved is important given the crowded anatomy of ligaments, menisci, and capsule surrounding the knee.
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
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.