0UC13ZZ
Extirpation Ovary, Left to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | C Extirpation |
| Body Part | 1 Ovary, Left |
| 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
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
Ovary, Left
The left ovary mirrors its right-sided counterpart in structure and hormonal function, sitting in the pelvis and connected by the same ligamentous supports. Extirpation applies when abnormal material, such as clotted blood, purulent debris, or necrotic tissue from a torsed or ruptured cyst, is removed from the ovarian surface or interior without excising ovarian tissue itself. Surgeons pursue this fertility-sparing approach particularly in younger patients where preserving oocyte reserve is a priority, evacuating the abnormal contents while leaving viable cortex intact. Because left and right ovaries are coded as distinct body parts, accurate laterality documentation is essential, and the operative note should make clear that the procedure was limited to removal of abnormal material rather than any portion of the ovary.
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
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.
