06DN0ZZ
Extraction Femoral Vein, Left to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 6 Lower Veins |
| Operation | D Extraction |
| Body Part | N Femoral Vein, Left |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z 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 in this family refers to pulling or stripping an entire vein, or a long segment of one, out of the leg using mechanical force rather than cutting it away piece by piece. The most familiar example is traditional saphenous vein stripping for severe varicose vein disease, where a rigid or flexible stripper is threaded the length of the vein and the vessel is then pulled out through one or two small incisions.
This procedure is chosen when varicose veins are extensive, symptomatic, and not well suited to less invasive options like ablation, or when a vein needs to be removed in its entirety rather than in sections. Because the whole vessel is drawn out under tension, it differs meaningfully from procedures that cut the vein into segments or seal it shut without physically withdrawing it.
Recovery generally involves some bruising and soreness along the path the vein was pulled from, and compression stockings are commonly used afterward to support healing and reduce swelling in the leg.
Anatomy & Axis Detail
Femoral Vein, Left
The left femoral vein, positioned within the femoral triangle alongside the artery and nerve, may undergo extraction when chronic or organized thrombus is adherent to the vessel wall and must be pulled free rather than simply aspirated or dissolved. This scenario often arises in post-thrombotic disease where earlier untreated deep vein thrombosis has left fibrotic material narrowing the lumen. Because forceful extraction carries a higher risk of endothelial and valvular injury than gentler extirpation techniques, it is generally reserved for cases where less traumatic methods have failed to clear the vessel. Given the higher background rate of left-sided iliofemoral thrombosis related to venous compression, this vein is a relatively common site for such interventions, and documentation should clarify that material was physically pulled out rather than excised or ablated.
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
The operative note should describe a stripping device or similar instrument being passed through the vein and the vessel being pulled out under force, which is the defining feature that supports Extraction rather than Excision. Coders should confirm which vein was stripped, most often the great or small saphenous vein, and whether the entire length or only a portion was removed, since character selection depends on the specific body part value available for lower veins.
A common mistake is applying Extraction to endovenous procedures that actually use heat, laser, or chemical means to close the vein in place, such as radiofrequency or laser ablation, which belong under Destruction because the vein is not physically pulled out. Another frequent error is coding partial stab avulsion of varicose tributaries as Extraction when the documentation better supports Excision, since avulsion of short segments through small punctures is typically closer to cutting out portions of vein rather than stripping the full vessel by force.