0TC13ZZ
Extirpation Kidney, Left to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | C Extirpation |
| Body Part | 1 Kidney, Left |
| 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 covers procedures that physically remove solid material from inside a urinary structure without cutting out any of the structure itself. Classic examples include removing a kidney or bladder stone through an open or endoscopic approach, clearing a blood clot obstructing the bladder, or taking out debris that has collected in a ureter. The material removed is abnormal - it does not belong there - and the underlying organ stays intact once it is gone.
Anatomy & Axis Detail
Kidney, Left
The left kidney sits slightly higher in the retroperitoneum than its right counterpart, positioned beneath the spleen and diaphragm, and extirpation from this organ involves physically removing solid material such as a renal calculus, calcified debris, or an obstructing clot from the parenchyma or collecting system. This procedure is distinct from destruction or excision because the abnormal material itself, not tissue, is what is being taken out, and it commonly correlates with percutaneous nephrolithotomy or open stone extraction for large or complex left-sided stones. The left kidney's relationship to the splenic flexure and tail of the pancreas can influence percutaneous access planning, and any residual fragments left in place after lithotripsy should be reflected accurately in the documentation, since only material actually removed is coded here.
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 coder needs documentation confirming that the object removed was solid matter foreign to normal anatomy, such as a calculus, clot, or necrotic material, and that no tissue resection occurred alongside it. The specific site and approach (percutaneous, transurethral, open) determine the code. A common assignment error is coding stone removal as Fragmentation when the stone was broken up and then extracted as pieces - if fragments are actually retrieved and removed, Extirpation may apply to the retrieval step in addition to Fragmentation for the breaking-up step, and coders sometimes capture only one of the two.