0QCN4ZZ
Extirpation Metatarsal, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | C Extirpation |
| Body Part | N Metatarsal, Right |
| Approach | 4 Percutaneous Endoscopic |
| 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
Metatarsal, Right
Extirpation of the right metatarsal bones removes solid material - infected bone, retained foreign objects, or necrotic debris - from one or more of the five long bones spanning the midfoot to the toes. These bones are frequently affected by diabetic foot infections, osteomyelitis from chronic ulcers, or penetrating trauma, since their relatively thin cortices and superficial dorsal location make them vulnerable to contamination. Surgeons typically approach dorsally over the affected shaft, curetting the cavity to remove infected or necrotic material while trying to preserve enough bone stock to maintain forefoot structure and toe alignment. Because metatarsal integrity affects push-off during gait, clearance is balanced against the need to avoid destabilizing the bone, and this procedure is coded distinctly from ray amputation or metatarsal resection.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
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.