ICD-10-PCS Billable Code

0LB94ZZ

Excision Trunk Tendon, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemL Tendons
OperationB Excision
Body Part9 Trunk Tendon, Right
Approach4 Percutaneous Endoscopic
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

Trunk Tendon, Right

Trunk tendon excision on the right side applies to tendinous structures outside the named thorax and abdomen wall groupings, such as those associated with paraspinal or hip girdle musculature attaching along the trunk. These tendons are excised when chronic degeneration, calcific tendinopathy, or a symptomatic mass-like thickening causes localized pain or restricts motion, and the procedure removes the affected tissue without reconstructing the tendon. Because trunk tendons are less frequently operated on than limb tendons, precise anatomic description in the operative note is important to distinguish the specific structure involved from nearby fascia or ligamentous tissue, which can appear similar on gross inspection but are coded under different body systems.

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.

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.