0TC33ZZ
Extirpation Kidney Pelvis, Right 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 | 3 Kidney Pelvis, Right |
| 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 Pelvis, Right
The right kidney pelvis is the funnel-shaped, urine-collecting chamber where the major and minor calyces converge before draining into the ureter, and it is a common site for stone formation due to its role as a low-flow collecting reservoir. Extirpation from this structure removes solid material, most typically a renal pelvic calculus, lodged within the funnel itself rather than within the surrounding renal parenchyma, distinguishing this body part value from extirpation coded to the kidney proper. This is frequently accomplished through percutaneous nephrolithotomy or ureteroscopic basket extraction with fluoroscopic or endoscopic guidance. Because the pelvis can also be a site of obstructive pathology such as ureteropelvic junction narrowing, the operative note should clarify that the intervention targeted removal of an obstructing solid rather than repair of the junction itself.
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.