ICD-10-PCS Billable Code

0MDH3ZZ

Extraction Abdomen Bursa and Ligament, Right to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemM Bursae and Ligaments
OperationD Extraction
Body PartH Abdomen Bursa and Ligament, Right
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Pulling or stripping out or off all or a portion of a body part by the use of force

Procedure Overview

Extraction procedures pull or strip out all or part of a bursa or ligament using force, rather than by cutting. This root operation is used less often for bursae and ligaments than for structures like veins, but it applies when tissue is physically stripped away, for example when a scarred or adhered portion of a ligament is forcibly separated from surrounding structures during surgical mobilization.

Because the defining feature is force rather than sharp dissection, these procedures are typically reserved for situations where a structure is being avulsed or stripped rather than incised, such as forcibly detaching adherent tissue during a difficult revision procedure.

Extraction is chosen based on the surgical technique actually used, not the underlying condition, so the same clinical problem might be addressed with excision in one case and extraction in another depending on how the surgeon physically removed the tissue.

Anatomy & Axis Detail

Abdomen Bursa and Ligament, Right

On the right side of the abdomen, this body part designation includes ligaments such as the round ligament of the liver, falciform ligament attachments, and other abdominal wall ligamentous and bursal structures on that side. Extraction applies when the surgeon removes loose or contained material, such as a calcified nodule, cystic fluid and debris, or a foreign body fragment, from within one of these structures without excising the ligament itself. These ligaments are often encountered incidentally during abdominal surgery and are not always the primary indication for the operation, so documentation must clearly establish that the ligament or bursa was the actual target of the extraction rather than a structure merely divided or retracted to reach another organ.

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

Coders should look specifically for language describing pulling, stripping, or avulsing tissue by force, as opposed to cutting it with an instrument. This distinction can be subtle in operative notes, so close reading of the technique description is essential rather than assuming based on the diagnosis alone.

A common error is defaulting to Excision for any tissue removal without verifying whether the surgeon actually used a cutting instrument or physically stripped the tissue free, since these map to different root operations. Extraction is also uncommon enough in this body system that coders should double check the guidance and any coding clinic advice before assigning it.

Commonly Confused With

ExcisionExtraction is most easily confused with Excision, and the distinguishing factor is purely the mechanism, force versus cutting, described in the operative note.
ReleaseIt can also be confused with Release when adhesions are being freed, though Release targets constraining scar tissue around the structure rather than the ligament or bursa itself being pulled away.