ICD-10-PCS Billable Code

0VCH3ZZ

Extirpation Spermatic Cords, Bilateral to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemV Male Reproductive System
OperationC Extirpation
Body PartH Spermatic Cords, Bilateral
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Taking or cutting out solid matter from a body part

Procedure Overview

Extirpation removes solid material that does not belong in the body from a male reproductive structure, such as a calcified stone in the vas deferens, a blood clot obstructing the epididymis, or a foreign object lodged in the scrotal or penile tissue. Unlike excision, no normal body part is cut away; the surgeon is retrieving debris, a clot, or a stone that has formed or lodged within an otherwise intact structure.

This type of procedure is typically performed when the obstructing material is causing pain, blocking normal fluid flow, or risking infection, and imaging has identified a discrete mass of foreign or abnormal material rather than diseased tissue that needs to be sampled or removed. Retrieval can be done through a small incision, endoscopically, or under image guidance depending on where the material is located.

Anatomy & Axis Detail

Spermatic Cords, Bilateral

Bilateral extirpation of the spermatic cords involves clearing solid abnormal material, such as calcified debris, organized clot, or infected tissue, from within the coverings of both cords in a single operative episode. This scenario typically reflects a process affecting both sides at once, such as bilateral chronic funiculitis, symmetric calcified hematomas from prior trauma, or an infection that has spread along both cords from a shared source. Because each cord independently carries the vas deferens and the testicular vascular supply for its respective side, surgeons must address the right and left structures separately even within one procedure, taking care to avoid compromising fertility or testicular perfusion on either side. Coding it as bilateral captures that both cords were treated together rather than as two isolated unilateral procedures.

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

The note must describe removal of solid matter, such as a calculus, thrombus, or foreign body, from within a structure rather than removal of the structure's own tissue. Coders should look for words like stone, clot, or foreign body extraction rather than biopsy or resection, since those point toward Excision or Resection instead. A common error is coding drainage of an organized hematoma as Drainage when the clot has become solid and is being physically removed, which should be Extirpation; the distinction hinges on whether the material is fluid enough to be aspirated or has organized into a solid mass requiring extraction.

Commonly Confused With

DrainageDrainage is the most frequent point of confusion, since both address unwanted material within a body part; the deciding factor is physical state, with liquid or gas removed as Drainage and solid matter removed as Extirpation.
ExcisionExcision can also overlap in cases where a stone has become embedded in tissue that must be cut to free it; if any of the surrounding organ tissue is also taken out, the procedure may need to be coded as both Extirpation and Excision depending on what the documentation supports.