0MC90ZZ
Extirpation Upper Extremity Bursa and Ligament, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | C Extirpation |
| Body Part | 9 Upper Extremity Bursa and Ligament, Right |
| Approach | 0 Open |
| 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
Upper Extremity Bursa and Ligament, Right
Upper extremity bursa and ligament on the right side is a broader grouping used when the targeted structure does not correspond to a more specific body part such as the shoulder, elbow, or wrist, encompassing bursae and ligamentous bands along the arm and forearm outside those named joints. Extirpation applies when solid material, such as a calcified deposit within a bursal sac or an organized hematoma tracking along a ligament, needs to be taken out without removing the ligament or excising the bursa. This code is used judiciously, since more specific upper extremity body parts should be selected when the anatomy allows, and its use signals that the abnormal material was found in a bursa or ligament not otherwise classified along the limb's length.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
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.