ICD-10-PCS Billable Code

0QCK3ZZ

Extirpation Fibula, 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 PartK Fibula, 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

Fibula, Left

For the left fibula, extirpation removes solid abnormal matter such as necrotic bone, infected debris, or a foreign body from this thin lateral lower-leg bone, often following trauma, open fracture, or chronic infection. Though the fibula bears relatively little axial load compared to the tibia, its distal portion forms the lateral malleolus and is essential to ankle joint stability, so surgeons take care preserving that region during debridement. The approach is generally lateral, with curettage or mechanical clearance used to reach viable bone while avoiding unnecessary disruption of the shaft's continuity, which supports muscle attachments and interosseous membrane integrity. Documentation should reflect that the procedure was limited to extracting solid material rather than removing a segment of the fibula as excision or resection would involve.

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).