0UC74ZZ
Extirpation Fallopian Tubes, Bilateral to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | C Extirpation |
| Body Part | 7 Fallopian Tubes, Bilateral |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Taking or cutting out solid matter from a body part
Procedure Overview
Extirpation covers taking or cutting solid matter out of the female reproductive tract that does not belong there - this includes removing blood clots, retained products of conception, calcified tissue, or foreign objects, as opposed to removing a piece of an organ itself. A common example is evacuation of retained placental tissue after delivery or miscarriage, or removal of a calcified fibroid fragment that has become dislodged.
This root operation is used when the material being removed is abnormal or misplaced rather than a normal anatomical structure, and the goal is simply to clear it out rather than to treat the organ housing it. Clinically, patients undergo these procedures for incomplete miscarriage, postpartum hemorrhage from retained tissue, or infections associated with foreign material like a lost IUD fragment.
Because the matter being removed is not itself living tissue that is part of the organ, extirpation is conceptually distinct from cutting into an organ to take a sample of that organ's own structure.
Anatomy & Axis Detail
Fallopian Tubes, Bilateral
Bilateral involvement of both fallopian tubes with abnormal material requiring removal, such as bilateral hydrosalpinx contents, purulent debris from bilateral salpingitis, or hemorrhagic material, is coded to this combined body part when both tubes are addressed during the same operative encounter. The procedure removes the abnormal substance from within or on the surface of each tube while preserving the tubal walls themselves, distinguishing it from bilateral salpingectomy. Bilateral tubal disease often reflects ascending infection or diffuse inflammatory processes affecting the adnexa symmetrically, and because fertility implications differ significantly from tube removal, operative documentation should clearly establish that both tubes were involved and that only abnormal material, not tubal tissue, was excised.
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
Coding support requires documentation that identifies the material removed as solid matter - clot, retained products of conception, calculus, or foreign body - rather than as a specimen of the organ's own tissue. Operative notes describing dilation and curettage for retained products, or laparoscopic removal of a dislodged device, typically support this code. The body part value should reflect the anatomical site where the extraction occurred, such as the uterus for a D&C performed for retained products.
The recurring mistake is coding a D&C as Extraction when the documentation actually describes cutting or curetting out solid matter, since D&C procedures for retained products of conception are classified as Extirpation rather than Extraction, which is reserved for pulling or stripping tissue out by force. Coders also occasionally miss that a D&C performed to obtain an endometrial sample for diagnosis is coded differently, since that involves a different intent and root operation.