0TC00ZZ
Extirpation Kidney, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | C Extirpation |
| Body Part | 0 Kidney, 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
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, Right
The right kidney is a retroperitoneal, bean-shaped organ responsible for filtering blood and producing urine, and extirpation of solid matter from it targets material the body cannot break down or pass on its own. This most often means removal of a staghorn or otherwise impacted calculus lodged within the collecting system or renal substance, performed via an open, percutaneous, or endoscopic approach depending on stone burden and location. Unlike extraction of fluid or tissue removal for disease, extirpation here specifically addresses solid, abnormal material such as a stone, clot, or foreign body that is physically taken out rather than cut away as tissue. The right kidney's lower position relative to the left, due to the liver above it, can influence percutaneous access angles and should be reflected in documentation of approach.
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
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.