ICD-10-PCS Billable Code

0VC74ZZ

Extirpation Tunica Vaginalis, Left to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemV Male Reproductive System
OperationC Extirpation
Body Part7 Tunica Vaginalis, Left
Approach4 Percutaneous Endoscopic
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

Tunica Vaginalis, Left

The left tunica vaginalis, the serosal covering that cushions the left testis and permits its gliding motion within the scrotal sac, is the site addressed when extirpation is performed to remove solid material such as calcified plaques, organized clot, or thickened infected fluid trapped within this potential space. Chronic hydrocele that has calcified, a longstanding hematocele from trauma, or an infected collection that has become semisolid are typical reasons this material must be physically removed rather than simply drained. The close relationship of the tunica to the testis and epididymis on the left side demands careful technique to avoid compromising these adjacent structures during removal. As with its right-sided counterpart, laterality must be recorded precisely since the two sides are separate coded body parts.

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 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.