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Extirpation Hip Tendon, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | C Extirpation |
| Body Part | J Hip Tendon, Right |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Taking or cutting out solid matter from a body part
Procedure Overview
Tendon extirpation procedures take or cut out solid matter that has formed within or around a tendon but is not itself normal tendon tissue, such as a foreign body, a blood clot, or a calcified deposit that has hardened within the tendon. This differs from removing part of the tendon structure itself, since the target here is abnormal material lodged in or against the tendon rather than the tendon's own tissue.
Common scenarios include removing a splinter or suture fragment that migrated into a tendon sheath, evacuating an organized hematoma that has not resolved on its own, or extracting calcific deposits associated with calcific tendinitis that have become symptomatic. The surgeon may need to make an incision to access and extract the material, and the procedure is considered complete once the solid matter is out, without any tendon tissue itself being excised.
Anatomy & Axis Detail
Hip Tendon, Right
The hip tendon group includes tendons such as the iliopsoas and gluteal tendons that cross the hip joint to enable flexion, extension, and rotation, and extirpation on the right side is commonly performed to remove calcific deposits associated with calcific tendinitis, a bursal-adjacent calcification, or debris from chronic impingement. The iliopsoas tendon in particular can develop a discrete calcific focus near its insertion on the lesser trochanter, producing groin pain that prompts imaging and subsequent removal. Surgeons may approach the hip tendon through an open or arthroscopically assisted technique, carefully working around the femoral neurovascular bundle when addressing the anterior iliopsoas tendon. Clear identification of which hip tendon was involved, iliopsoas versus a gluteal or other tendon, supports accurate coding since the hip region contains several distinct tendinous structures in close proximity.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Coding & Documentation
Extirpation is coded when documentation describes removing solid matter, abnormal by presence or amount, from within or around the tendon, distinct from removing a piece of the tendon itself. The note should specify what was extracted, such as a calcific deposit, foreign body, or organized clot, and the tendon or region involved.
A frequent coding error is applying Extirpation to routine debridement of degenerated tendon tissue, which actually belongs under Excision because that tissue is part of the tendon rather than foreign or abnormal material lodged within it. Coders also sometimes miss that if the extracted material is accompanied by simple fluid drainage in the same operative field, both actions may need separate codes depending on what exactly was documented as removed.