0MC14ZZ
Extirpation Shoulder Bursa and Ligament, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | C Extirpation |
| Body Part | 1 Shoulder Bursa and Ligament, 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 procedures take or cut out solid matter that does not belong in a bursa or ligament, such as calcified deposits, loose bodies, blood clots, or foreign material. Unlike excision, the material removed is abnormal rather than being a piece of the ligament or bursa itself. A common scenario is removal of calcific deposits from a chronically inflamed bursa, sometimes called calcific bursitis, or clearing a hematoma that has formed within a ligament sheath after injury.
These procedures are often performed when conservative treatment or drainage alone has failed to resolve symptoms caused by the trapped material. The approach may be open, arthroscopic, or through a small percutaneous access depending on the size and location of the deposit.
By removing the obstructing or irritating material, extirpation aims to relieve pain and restore normal movement without removing any of the surrounding healthy ligament or bursa tissue.
Anatomy & Axis Detail
Shoulder Bursa and Ligament, Right
The right shoulder's bursae and ligaments include the subacromial and subdeltoid bursae along with the glenohumeral and coracoacromial ligaments that support this highly mobile joint. Extirpation removes abnormal solid material, such as calcific deposits from calcific tendinitis or bursitis, loose debris, or a foreign body, from within the bursa or ligament without excising the structure itself. This is a common procedure for calcific subacromial bursitis, where deposits are removed arthroscopically to relieve pain and restore motion while preserving the bursa's cushioning function. Given the shoulder's wide range of motion and reliance on these soft tissue structures for stability, care is taken to remove only the abnormal material and avoid destabilizing the joint.
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
The documentation should identify the removed material as abnormal solid matter, such as calcium deposits, debris, or a clot, rather than native tissue. Coders should look for terms like removal, debris clearance, or evacuation of calcification rather than excision or resection language.
A common mistake is defaulting to Excision whenever tissue is cut, without checking whether what was actually removed was foreign or abnormal material versus a piece of the ligament or bursa itself. When both native tissue and abnormal material are removed in the same operative episode, coders must determine whether one procedure was incidental to the other or whether both should be captured.