ICD-10-PCS Billable Code

0NB30ZZ

Excision Parietal Bone, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemN Head and Facial Bones
OperationB Excision
Body Part3 Parietal Bone, Right
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

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

Procedure Overview

Excision procedures remove a portion of a skull or facial bone without replacing it, typically to obtain a tissue sample for diagnosis or to eliminate a localized area of diseased or abnormal bone. A surgeon cuts away the affected segment while leaving the rest of the bone intact, distinguishing this from procedures that remove an entire bone or joint. The removed piece may be sent to pathology to confirm whether a lesion is benign or malignant, or it may be taken simply because the bone itself is infected, fractured beyond repair in that spot, or overgrown.

This family covers situations ranging from a small biopsy of a suspicious jaw lesion to excising a section of skull affected by chronic osteomyelitis or a benign tumor such as an osteoma. Facial bone excisions are also performed to correct congenital deformities or to remove bone that is compressing a nerve or interfering with normal function. Because the skull and face have limited soft-tissue coverage in places, surgeons plan these excisions carefully to preserve surrounding structures like nerves, sinuses, and the dura covering the brain.

Anatomy & Axis Detail

Parietal Bone, Right

The right parietal bone forms much of the lateral and superior skull vault on that side, lying over the parietal lobe of the brain, and excision of a portion of it is performed to remove a bony lesion such as an osteoma, a focus of Paget's disease or fibrous dysplasia, or to biopsy suspicious bone in a case of suspected metastasis or infection. Because this bone is relatively broad and convex with no major foramina, focal excisions are technically straightforward compared to skull base bones, but the underlying dura and venous sinuses near the midline still require careful protection during the cut. The right-sided designation matters for accurate lateral localization, and documentation should specify the size and location of the excised segment relative to cranial landmarks.

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

Coders should look for clear documentation that only part of the bone was removed, since excision of an entire bone or a specific named part in total corresponds to Resection rather than Excision. The pathology report and operative note together typically establish whether a biopsy excision was diagnostic or therapeutic, though the root operation is the same either way. A common assignment mistake is selecting Excision when the documentation actually describes a craniectomy performed to access the brain rather than to remove diseased bone, in which case the bone opening may be incidental to a different procedure performed on a different body system. Coders should also confirm the specific facial bone involved, since the body system table for Head and Facial Bones lists distinct values for structures like the mandible, maxilla, orbit, and nasal bone, and picking the wrong one is a frequent error.

Commonly Confused With

ResectionExcision is easily confused with Resection, and the deciding factor is completeness: Resection applies when an entire bone or a formally defined anatomical portion of it is cut out, while Excision applies to a partial removal.
ExtractionIt also overlaps with Extraction, which applies force to pull or strip tissue rather than cutting it out, a distinction that matters when a lesion is curetted or scraped rather than sharply excised.