0UC28ZZ
Extirpation Ovaries, Bilateral to No Qualifier with No Device, Via Natural or Artificial Opening Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | C Extirpation |
| Body Part | 2 Ovaries, Bilateral |
| Approach | 8 Via Natural or Artificial Opening Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Taking or cutting out solid matter from a body part
Procedure Overview
Extirpation covers taking or cutting solid matter out of the female reproductive tract that does not belong there - this includes removing blood clots, retained products of conception, calcified tissue, or foreign objects, as opposed to removing a piece of an organ itself. A common example is evacuation of retained placental tissue after delivery or miscarriage, or removal of a calcified fibroid fragment that has become dislodged.
This root operation is used when the material being removed is abnormal or misplaced rather than a normal anatomical structure, and the goal is simply to clear it out rather than to treat the organ housing it. Clinically, patients undergo these procedures for incomplete miscarriage, postpartum hemorrhage from retained tissue, or infections associated with foreign material like a lost IUD fragment.
Because the matter being removed is not itself living tissue that is part of the organ, extirpation is conceptually distinct from cutting into an organ to take a sample of that organ's own structure.
Anatomy & Axis Detail
Ovaries, Bilateral
When both ovaries harbor abnormal material requiring removal in the same operative episode, such as bilateral hemorrhagic cysts or bilateral endometriotic debris, the procedure is coded to the bilateral ovaries body part rather than reported twice for each side. This root operation removes the abnormal substance, blood, necrotic tissue, or infectious debris, from the surface or interior of each ovary while sparing the underlying ovarian parenchyma, distinguishing it from bilateral oophorectomy. Bilateral involvement often reflects a systemic or diffuse process, such as severe endometriosis or a coagulopathy-related hemorrhagic event, rather than an isolated unilateral abnormality, and documentation should confirm that both ovaries were addressed within the same surgical session to justify use of the bilateral code rather than two separate laterality codes.
Approach: Via Natural or Artificial Opening Endoscopic
Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.
Coding & Documentation
Coding support requires documentation that identifies the material removed as solid matter - clot, retained products of conception, calculus, or foreign body - rather than as a specimen of the organ's own tissue. Operative notes describing dilation and curettage for retained products, or laparoscopic removal of a dislodged device, typically support this code. The body part value should reflect the anatomical site where the extraction occurred, such as the uterus for a D&C performed for retained products.
The recurring mistake is coding a D&C as Extraction when the documentation actually describes cutting or curetting out solid matter, since D&C procedures for retained products of conception are classified as Extirpation rather than Extraction, which is reserved for pulling or stripping tissue out by force. Coders also occasionally miss that a D&C performed to obtain an endometrial sample for diagnosis is coded differently, since that involves a different intent and root operation.