ICD-10-PCS Billable Code

0QC23ZZ

Extirpation Pelvic Bone, Right to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
OperationC Extirpation
Body Part2 Pelvic Bone, Right
Approach3 Percutaneous
DeviceZ No Device
QualifierZ 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

Pelvic Bone, Right

The right pelvic bone, the innominate bone made up of the ilium, ischium, and pubis, forms half of the bony pelvic ring and anchors the hip joint as well as major muscles of the trunk and lower limb. Extirpation from this bone removes solid abnormal material, such as a sequestrum from chronic osteomyelitis, a foreign body embedded after a gunshot or crush injury, or necrotic debris from a nonunion fracture site, leaving the bone itself otherwise intact. Because the pelvic bone is thick and irregularly shaped with numerous muscular and ligamentous attachments, locating and removing embedded material can require extensive exposure, and documentation should indicate which of its three component regions, iliac wing, ischial tuberosity, or pubic ramus, was involved.

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

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.

Commonly Confused With

ExcisionThe key distinction from Excision is that extirpation removes matter that is not a normal part of the body part - dead or foreign material - while excision cuts a portion of a body part that is still living tissue.
ExtractionExtirpation is also distinct from Extraction, which pulls material out using force rather than simply lifting or removing loose fragments, and from Removal (a different root operation used for devices, not native tissue).