X2CQ3T7
Extirpation Upper Extremity Vein, Right to New Technology Group 7 with Computer-aided Mechanical Aspiration, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | X New Technology |
| Body System | 2 Cardiovascular System |
| Operation | C Extirpation |
| Body Part | Q Upper Extremity Vein, Right |
| Approach | 3 Percutaneous |
| Device | T Computer-aided Mechanical Aspiration |
| Qualifier | 7 New Technology Group 7 |
Operation Definition
Taking or cutting out solid matter from a body part
Procedure Overview
This family describes removing solid material, such as clot, embolic debris, or calcified plaque, from a blood vessel using a newer technology device, without cutting through the vessel wall to separate a body part. These procedures are typically performed for patients with an acute blockage, such as a clot lodged in a coronary or peripheral artery, or significant plaque buildup that is restricting blood flow and can't be adequately treated by dilation alone.
The goal is to physically extract the obstructing material and restore normal blood flow, using a device recognized under New Technology criteria for its distinct mechanism of capturing, aspirating, or shaving away the material compared to older tools.
Anatomy & Axis Detail
Upper Extremity Vein, Right
Upper extremity veins on the right side, including the axillary, subclavian, and brachial venous segments, can become occluded by thrombus from central catheters, effort-related clotting, or hypercoagulable states. Extirpation of this material involves a catheter-based device advanced into the vein to mechanically extract or macerate and aspirate the clot, restoring venous outflow from the arm without removing or repairing the vessel wall. Because these veins are thin-walled and closely associated with the brachial plexus and subclavian artery, device selection favors techniques that minimize vessel trauma, and right-sided documentation is distinguished from the left given differing catheter approaches and the asymmetry of thoracic outlet anatomy.
Approach: Percutaneous
In New Technology, Percutaneous describes entry into the body via needle or instrument puncture through the skin or a mucous membrane, without a surgical incision, mirroring the same concept in Medical and Surgical. It is distinguished from Open access, which requires a full incision, and from Percutaneous Endoscopic, which adds visualization through the puncture site.
Device / Substance / Technology: Computer-aided Mechanical Aspiration
This value describes a mechanical aspiration device that incorporates computer-aided control to optimize thrombus or debris removal, typically in vascular or neurovascular thrombectomy procedures. The computer assistance differentiates it from standard mechanical aspiration systems by adjusting suction parameters or guidance during the procedure. It is used specifically when this software-enhanced capability is part of the device, not for conventional manual aspiration catheters.
Qualifier: New Technology Group 7
As a qualifier value, Group 7 marks a code as belonging to the set of new technologies approved for use in the 2020-2021 fiscal year, a period that included a notable expansion of infectious-disease-related add-on codes. The label does not describe what the technology does; that detail sits in the table and other axis values. It is distinguished from adjoining groups solely by its approval-year cohort.
Coding & Documentation
Documentation needs to identify the specific device or technology used, the vessel and approach, and confirm that solid matter, rather than fluid, was removed, since that distinguishes Extirpation from Drainage. A recurring error is coding a thrombectomy or atherectomy performed with a standard, non-qualifying device under this New Technology table instead of the appropriate Medical and Surgical extirpation code, or overlooking documentation of the device that would justify the New Technology assignment.
Commonly Confused With
This family is often confused with Fragmentation, which breaks solid matter into pieces without removing it, and with Extraction, which pulls out a body part rather than abnormal material within it. The differentiator is whether the material removed is solid matter obstructing the vessel, pointing to Extirpation, versus tissue of the body part itself or fragments left in place.