07DS3ZX
Extraction Bone Marrow, Vertebral to Diagnostic with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | D Extraction |
| Body Part | S Bone Marrow, Vertebral |
| Approach | 3 Percutaneous |
| Device | Z No Device |
| Qualifier | X Diagnostic |
Operation Definition
Pulling or stripping out or off all or a portion of a body part by the use of force
Procedure Overview
Extraction in this body system almost always refers to bone marrow procedures - pulling out marrow tissue using a needle and manual force rather than a cutting instrument. A physician advances a needle into the marrow cavity, usually at the posterior iliac crest, and withdraws either a liquid marrow sample by aspiration or a solid core sample by twisting and pulling the needle free.
These procedures are performed to evaluate blood cell production when someone has unexplained anemia, abnormal blood counts, a suspected blood cancer, or to stage lymphoma. The same technique, at larger volume, is used to harvest marrow for a stem cell or bone marrow transplant, where the marrow is collected from a donor rather than for diagnosis.
Because the tissue is pulled or stripped out by force rather than sliced away, this family sits apart from ordinary biopsy techniques used on solid organs, even though the clinical intent, sampling tissue for evaluation, is similar.
Anatomy & Axis Detail
Bone Marrow, Vertebral
Vertebral bone marrow lies within the cancellous bone of the vertebral bodies and is not a routine sampling site, generally accessed only when other locations are unsuitable or when a lesion identified on imaging within the spine specifically needs tissue diagnosis. Extraction of vertebral marrow involves advancing a needle into the vertebral body, typically under fluoroscopic or CT guidance given the proximity of the spinal canal, nerve roots, and major vessels running along the spine. This approach carries meaningfully higher procedural risk than iliac sampling and is therefore reserved for targeted diagnostic questions, such as confirming marrow involvement by a tumor already visualized at that level, rather than for routine hematologic workup.
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.
Qualifier: Diagnostic
Applied chiefly to Excision, this qualifier marks that tissue was removed specifically for diagnostic purposes, i.e., a biopsy intended for pathologic evaluation rather than to treat disease. It distinguishes biopsy-type excisions from therapeutic excisions of the same body part, which are coded without this qualifier even though the physical technique may be identical.
Coding & Documentation
Coders need documentation specifying whether the procedure was a marrow aspiration (liquid marrow withdrawn by syringe), a core biopsy (a solid cylinder of marrow pulled out with a biopsy needle), or both, since both are captured under Extraction but the approach and diagnostic qualifier may differ. The note should confirm the bone marrow was the target, not a separate skeletal structure, since a bone biopsy with marrow incidentally obtained is coded differently.
A common mistake is defaulting to Excision because the word "biopsy" appears in the note; bone marrow biopsy is Extraction by PCS definition regardless of that word choice. Another error is failing to separately code an aspiration and a core biopsy performed at the same session through two separate needle passes, when guidelines call for capturing both.