0HCV3ZZ
Extirpation Breast, Bilateral to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | H Skin and Breast |
| Operation | C Extirpation |
| Body Part | V Breast, Bilateral |
| Approach | 3 Percutaneous |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Taking or cutting out solid matter from a body part
Procedure Overview
Extirpation procedures take or cut solid matter out of skin or breast tissue, most often material that does not belong there, such as a foreign body, a blood clot, or dead and infected tissue that needs to be cleared away. Nonexcisional debridement of a wound, where nonviable tissue is scraped, washed, or picked away rather than sharply cut out, is a frequent example, as is removal of an embedded splinter, suture fragment, or other foreign object from the skin.
This family is distinct because the material being removed is often not normal body tissue at all, or is dead tissue that has lost its normal structure and function. The purpose is usually to clear away something that is causing infection, blocking healing, or otherwise does not belong, rather than to treat a structural abnormality of the tissue itself.
Anatomy & Axis Detail
Breast, Bilateral
Bilateral breast extirpation describes the same removal of solid, non-parenchymal matter, such as necrotic debris, calcified fat necrosis, or extravasated implant material, performed on both breasts during a single encounter, and is coded to the bilateral body part value rather than reported twice. This situation arises when a systemic process, symmetric implant rupture, or bilateral infection affects both breasts simultaneously, requiring parallel clearance procedures on each side. As with unilateral extirpation, the goal is to remove abnormal material while preserving glandular and fibrofatty tissue, keeping the procedure distinct from bilateral excision or resection. Coding to the bilateral value depends on both breasts undergoing the same root operation during the same operative episode; if the two sides required different procedures, they would instead be reported separately using the right and left body part values.
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
The note needs to identify what solid matter was removed and how, since the method used to remove necrotic tissue is the key variable coders must track: sharp surgical cutting of dead tissue with a scalpel is excisional debridement and belongs to Excision, while scraping, brushing, or irrigating it away is nonexcisional and belongs to Extirpation. This distinction is the most common source of error in this family, and coders should look for specific verbs like "sharply debrided" versus "scraped" or "irrigated" rather than assuming based on the word debridement alone. Foreign body removal cases can also be miscoded when the note is vague about whether the object was cut free from surrounding tissue, which would introduce an Excision component.