0TC74ZZ
Extirpation Ureter, Left to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | C Extirpation |
| Body Part | 7 Ureter, Left |
| 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 covers procedures that physically remove solid material from inside a urinary structure without cutting out any of the structure itself. Classic examples include removing a kidney or bladder stone through an open or endoscopic approach, clearing a blood clot obstructing the bladder, or taking out debris that has collected in a ureter. The material removed is abnormal - it does not belong there - and the underlying organ stays intact once it is gone.
Anatomy & Axis Detail
Ureter, Left
The left ureter is the narrow, muscular tube conveying urine from the left kidney to the bladder, and it shares with the right ureter several anatomic narrowings, at the ureteropelvic junction, where it crosses the iliac vessels, and at its entry into the bladder, that predispose to stone impaction. Extirpation from the left ureter describes the removal of solid obstructing material such as a calculus, clot, or necrotic debris from within the lumen, most often via ureteroscopic basket extraction or, for larger stones, after fragmentation by laser or pneumatic lithotripsy. Documentation should distinguish material physically extracted from fragments left to pass spontaneously, since only the removed portion is coded, and should confirm laterality clearly, as right and left ureteral procedures carry distinct body part values despite identical technique.
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 coder needs documentation confirming that the object removed was solid matter foreign to normal anatomy, such as a calculus, clot, or necrotic material, and that no tissue resection occurred alongside it. The specific site and approach (percutaneous, transurethral, open) determine the code. A common assignment error is coding stone removal as Fragmentation when the stone was broken up and then extracted as pieces - if fragments are actually retrieved and removed, Extirpation may apply to the retrieval step in addition to Fragmentation for the breaking-up step, and coders sometimes capture only one of the two.