0QCB0ZZ
Extirpation Lower Femur, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | C Extirpation |
| Body Part | B Lower Femur, 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 of the lower bones is the removal of solid material that doesn't belong there - a loose bone fragment, a piece of dead bone (sequestrum) left behind by infection, or debris lodged in the bone following trauma. Unlike cutting away living bone tissue, this procedure clears out material that is already separated or non-viable, which is why it's often paired with treating osteomyelitis or cleaning up after a fracture.
Patients typically undergo this when imaging or prior surgery has identified fragments that are causing pain, blocking healing, or perpetuating an infection. Removing the material can relieve symptoms and allow the surrounding bone to heal normally.
Anatomy & Axis Detail
Lower Femur, Right
Extirpation of the right lower femur addresses solid abnormal material lodged within or on the distal femoral shaft, metaphysis, or condylar region - most often sequestered bone fragments from osteomyelitis, necrotic debris, cement or hardware remnants, or a foreign body embedded after trauma. The distal femur's proximity to the knee joint and its role bearing axial load make thorough clearance important, since retained infected or necrotic material can seed the adjacent joint or undermine future reconstruction. Surgeons typically approach through a lateral or anterior incision, curetting or excavating the material while preserving as much viable cortical and cancellous bone as possible. Documentation should specify that only the abnormal material was taken out, not a formal bone resection, since coders distinguish extirpation from excision or resection based on whether normal tissue was also removed.
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
Look for documentation describing removal of a sequestrum, loose body, necrotic bone fragment, or foreign material from within a lower bone. Sequestrectomy for chronic osteomyelitis is a classic example. The material removed should be distinguishable from the bone itself - it's being taken out of the bone, not cut from it. A frequent coding mistake is defaulting to excision whenever a bone procedure is described, without checking whether the surgeon was actually removing a discrete, already-separated fragment versus cutting living bone; the two require different root operations even when performed through the same incision.