ICD-10-PCS Billable Code

0QC93ZZ

Extirpation Femoral Shaft, Left to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
OperationC Extirpation
Body Part9 Femoral Shaft, Left
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Taking or cutting out solid matter from a body part

Procedure Overview

Extirpation of the lower bones is the removal of solid material that doesn't belong there - a loose bone fragment, a piece of dead bone (sequestrum) left behind by infection, or debris lodged in the bone following trauma. Unlike cutting away living bone tissue, this procedure clears out material that is already separated or non-viable, which is why it's often paired with treating osteomyelitis or cleaning up after a fracture.

Patients typically undergo this when imaging or prior surgery has identified fragments that are causing pain, blocking healing, or perpetuating an infection. Removing the material can relieve symptoms and allow the surrounding bone to heal normally.

Anatomy & Axis Detail

Femoral Shaft, Left

The left femoral shaft is the long central portion of the thigh bone lying between the proximal metaphysis and the distal femur, bearing the bulk of axial load during standing and walking and frequently fractured in high-energy trauma. Extirpation from this segment involves removing solid material that does not belong, such as a chronic osteomyelitic sequestrum, leftover cement following removal of an intramedullary nail or plate, or necrotic bony debris at a nonunion site, while leaving the femur's own structure intact. Because the femoral shaft is surrounded by dense musculature and situated near the femoral vessels, surgical access is planned carefully, and this procedure is often part of a staged treatment plan for infected hardware or a chronically infected fracture nonunion.

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

Look for documentation describing removal of a sequestrum, loose body, necrotic bone fragment, or foreign material from within a lower bone. Sequestrectomy for chronic osteomyelitis is a classic example. The material removed should be distinguishable from the bone itself - it's being taken out of the bone, not cut from it. A frequent coding mistake is defaulting to excision whenever a bone procedure is described, without checking whether the surgeon was actually removing a discrete, already-separated fragment versus cutting living bone; the two require different root operations even when performed through the same incision.

Commonly Confused With

ExcisionThe key distinction from Excision is that extirpation removes matter that is not a normal part of the body part - dead or foreign material - while excision cuts a portion of a body part that is still living tissue.
ExtractionExtirpation is also distinct from Extraction, which pulls material out using force rather than simply lifting or removing loose fragments, and from Removal (a different root operation used for devices, not native tissue).