0LCN3ZZ
Extirpation Lower Leg Tendon, Right to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | C Extirpation |
| Body Part | N Lower Leg Tendon, 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
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 Leg Tendon, Right
The lower leg tendons include the tibialis anterior, tibialis posterior, peroneal, and proximal Achilles tendon complex, all of which guide foot and ankle motion and are prone to friction injury within their sheaths. Extirpation targets abnormal solid contents such as calcific nodules, degenerated nodular tissue fragments, or foreign bodies lodged within or adjacent to the tendon sheath rather than the tendon itself. These tendons run in relatively superficial compartments along the shin and calf, so the surgeon can often localize the material through a small incision with direct visualization or ultrasound guidance. Because several tendons travel in close proximity in this region, precise identification of the specific tendon involved is essential for accurate documentation, and the procedure is distinguished from repair by the absence of any suturing of tendon fibers.
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
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.
