ICD-10-PCS Billable Code

0LC60ZZ

Extirpation Lower Arm and Wrist Tendon, Left to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemL Tendons
OperationC Extirpation
Body Part6 Lower Arm and Wrist Tendon, Left
Approach0 Open
DeviceZ No Device
QualifierZ 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

Lower Arm and Wrist Tendon, Left

On the left wrist and forearm, the flexor and extensor tendons are similarly susceptible to calcific tendinopathy, gouty deposits, or organized debris from repetitive strain, conditions that can produce a discrete mass suitable for extirpation rather than tendon excision. The left-sided procedure follows the same anatomic logic as the right, with the surgeon opening the tendon sheath at the point of maximal thickening or imaging abnormality to remove the solid material. Because the wrist houses closely packed tendon compartments separated by fibrous septa, precise identification of the affected compartment, whether dorsal extensor or volar flexor, is essential both for surgical planning and for coding accuracy. Postoperative management often emphasizes early protected motion to prevent adhesion formation at the site where the sheath was opened to retrieve the material.

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.

Commonly Confused With

ExcisionExcision is the most common point of confusion, and the deciding factor is whether the material removed is part of the tendon's own structure, which is Excision, or foreign or abnormal solid matter not native to the tendon, which is Extirpation.
DrainageDrainage overlaps when a collection contains both fluid and solid debris, in which case the predominant character of what was removed, and sometimes both actions if clearly documented, determines the correct code.
RepairRepair procedures sometimes follow extirpation to close the access incision, but a simple closure is not separately coded unless it involves a distinct reconstructive repair of the tendon.