ICD-10-PCS Billable Code

0PD90ZZ

Extraction Clavicle, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemP Upper Bones
OperationD Extraction
Body Part9 Clavicle, Right
Approach0 Open
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 on the upper bones involve pulling or stripping out a bone fragment or foreign material by force, rather than cutting it free surgically. In the upper skeleton, this applies to bones such as the clavicle, scapula, ribs, sternum, humerus, radius, ulna, and the small bones of the wrist, hand, and fingers. A surgeon uses this approach when a loose fragment, splinter, or embedded object needs to be pulled out without the more deliberate dissection that excision requires.

Patients most often encounter this after a fracture that has left small, unattached bone chips behind, or after trauma has driven a foreign object such as glass or metal into the bone. It can also come up during cleanup of an old injury site where a fragment never healed properly and continues to cause pain or limits movement. The goal is simply removal of material that does not belong, allowing the surrounding bone to heal or function normally.

Anatomy & Axis Detail

Clavicle, Right

The right clavicle is the long, S-shaped strut connecting the sternum to the acromion, subcutaneous along its length and prone to fracture from falls or direct trauma, which can leave displaced spicules or fragments embedded in surrounding tissue. Extraction of the clavicle refers to the forceful pulling out of such loose bone fragments or foreign material lodged within the bone rather than a planned resection of a bone segment. This is distinct from open reduction procedures, since no fixation or realignment is implied, only removal of material that has separated from the parent bone. Given the clavicle's superficial position and proximity to the brachial plexus and subclavian vessels, coders should verify from the operative note that the procedure was truly extraction of loose material and not excision, repair, or a more extensive fragment-clearing debridement.

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

A coder should look for documentation describing the fragment or object being pulled, avulsed, or stripped out, rather than language describing a planned cut through healthy bone. Operative notes that mention percutaneous fragment removal, forceps-assisted pulling, or manual extraction of debris support this root operation. Because the definition hinges on force rather than incision, the physician's precise wording matters more here than in most other bone procedures.

The most frequent assignment error is defaulting to Excision whenever any bone material is taken out. If the surgeon actually cuts around and detaches the fragment with an instrument, Excision is correct instead; Extraction applies only when the technique is genuinely pulling or forceful stripping. A second common mistake is missing that a qualifier for diagnostic versus therapeutic intent does not apply to Extraction the way it does to Excision, since Extraction has no diagnostic variant in this table.

Commonly Confused With

ExcisionExcision is the closest neighbor and the one most often confused with Extraction; the deciding factor is technique, cutting versus pulling, not the amount of bone involved.
RemovalRemoval is a separate family reserved for taking out a previously placed device, such as hardware, not native bone or foreign debris.
DivisionDivision, which cuts through bone without taking anything out, is sometimes mistaken for Extraction when a fragment is freed but left in place; if nothing leaves the body, Extraction does not apply.