ICD-10-PCS Billable Code

07CF0ZZ

Extirpation Lymphatic, Right Lower Extremity to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System7 Lymphatic and Hemic Systems
OperationC Extirpation
Body PartF Lymphatic, Right Lower Extremity
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Taking or cutting out solid matter from a body part

Procedure Overview

Extirpation in the lymphatic and hemic systems covers procedures that remove solid material that doesn't belong there, rather than removing a normal part of the body. Typical targets are a blood clot lodged in a lymphatic vessel, calcified debris in a lymph node, or an abscess pocket in the spleen. The material is taken out physically, by cutting, scraping, or suction, but the surrounding lymphatic structure itself is left in place.

This differs from taking a biopsy or removing an organ; the point of extirpation is clearing an obstruction or foreign substance so the vessel or organ can function normally again. It's often used when imaging shows a filling defect or mass that isn't a tumor to be resected but rather clotted or necrotic material to be evacuated. Recovery and follow-up depend on the underlying cause - a clot may signal a clotting disorder that needs separate treatment, while an abscess may require antibiotics afterward.

Anatomy & Axis Detail

Lymphatic, Right Lower Extremity

The lymphatic vessels and nodes of the right lower extremity run alongside the superficial and deep venous systems, including chains near the greater saphenous vein and the popliteal and femoral regions, and they are responsible for draining the leg and foot. Extirpation in this territory removes solid material obstructing or embedded within these channels - calcified debris, organized thrombus within a lymphatic vessel, or in endemic regions the calcified remains of filarial parasites - which differs from procedures aimed at excising malformed lymphatic tissue or performing a lymph node dissection for melanoma staging. Because chronic lymphedema is a common consequence of lymphatic obstruction in the leg, this procedure may be performed specifically to relieve blockage and restore drainage. The operative note should specify the abnormal material addressed so the distinction from destruction, excision, or resection of lymphatic tissue is clear.

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 operative note has to describe removal of abnormal solid matter - clot, calculus, necrotic debris, or similar - from within a lymphatic vessel, node, spleen, thymus, or bone marrow space, with the surrounding structure left intact. Documentation should make clear the material removed is not a piece of a normal body part; imaging or pathology confirming a thrombus or debris rather than tissue helps support the code choice.

The most common assignment error is mixing up extirpation with excision or resection when a coder sees "removed" in the note without checking whether what came out was abnormal matter or a portion of the organ itself. Another frequent slip is coding extirpation when the documentation actually describes drainage of fluid, which belongs under a different root operation, or when the clot removal was incidental to a larger resection, in which case only the more definitive procedure is coded.

Commonly Confused With

ExcisionExcision and Resection are the closest look-alikes: both cut into lymphatic tissue, but they remove a portion or all of a normal body part rather than abnormal material sitting within it.
DrainageDrainage is confused with extirpation when the substance removed is liquid rather than solid - a seroma or lymphocele aspirated from around a node is drainage, not extirpation.
FragmentationFragmentation, used elsewhere in PCS for breaking up solid matter without removing it, doesn't apply here since extirpation always ends with the material taken out of the body.