0UB17ZZ
Excision Ovary, Left to No Qualifier with No Device, Via Natural or Artificial Opening Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | B Excision |
| Body Part | 1 Ovary, Left |
| Approach | 7 Via Natural or Artificial Opening |
| 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
Ovary, Left
The left ovary, mirroring its right-sided counterpart, sits within the pelvic cavity attached by the mesovarium, suspensory ligament, and utero-ovarian ligament, and is excised for reasons such as a symptomatic or enlarging mass, endometrioma, torsion, or prophylactic removal in high-risk patients. Surgeons approaching the left adnexa must be mindful of the sigmoid colon's proximity, which can complicate dissection in cases of dense adhesions from prior endometriosis or infection, in contrast to the right side where the cecum and appendix are the neighboring structures. Removal of the left ovary alone leaves the right ovary to continue producing estrogen and progesterone, so this unilateral procedure is often chosen specifically to preserve fertility and endocrine function when disease is confined to one side. Precise laterality documentation is essential given the distinct surgical anatomy on each side.
Approach: Via Natural or Artificial Opening
Via Natural or Artificial Opening means the instrument reaches the target site by passing through an existing body orifice, such as the mouth or urethra, or a surgically created opening like a stoma, without additional incision or scope guidance. It is distinguished from the Endoscopic variant by the absence of a visualizing scope, and from External by actually traversing into the body through that opening.
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.