0LD00ZZ
Extraction Head and Neck Tendon to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | D Extraction |
| Body Part | 0 Head and Neck Tendon |
| 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
Tendon extraction procedures involve pulling or stripping out all or part of a tendon using mechanical force, most often to remove a tendon that has become severely diseased, calcified, or is being harvested for use elsewhere in the body. A common example is stripping the long saphenous vein equivalent in tendon work, such as harvesting the palmaris longus or a strip of hamstring tendon to serve as graft material for reconstructing a torn ligament or another damaged tendon. It is also used to remove a tendon that is chronically inflamed or fibrotic and no longer functions, when leaving it in place would cause ongoing pain or restrict motion.
Patients typically encounter this procedure as one step within a larger operation, such as ACL reconstruction using a hamstring autograft, rather than as a standalone treatment. The extracted tendon tissue is either discarded because it is diseased, or preserved and repositioned for grafting, which distinguishes this from a simple excision.
Anatomy & Axis Detail
Head and Neck Tendon
Head and neck tendons include structures such as the temporalis tendon inserting on the mandible and tendinous portions of muscles like the sternocleidomastoid and strap muscles of the neck, which are less commonly targeted surgically than limb tendons. Extraction in this region involves pulling or stripping tendinous tissue out by force, a technique occasionally used to harvest a segment for grafting elsewhere or to remove a damaged tendon segment following trauma. The dense concentration of vital structures in the head and neck, including major vessels, cranial nerves, and the airway, makes this an anatomically demanding site requiring meticulous exposure and hemostasis. Documentation should specify the exact tendon involved and reflect that the tissue was forcibly withdrawn rather than sharply excised, which distinguishes extraction from resection or excision coding.
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
Coders assign an extraction code from this family when documentation shows tendon tissue being pulled or stripped out by force, commonly during graft harvesting for ligament or tendon reconstruction elsewhere in the body. The operative note must specify that the tendon (not a ligament, muscle, or bursa) was the harvested structure and identify the specific tendon and body part value.
The most frequent assignment error is confusing extraction with excision when a portion of tendon is simply cut away rather than pulled out with force - excision applies when a scalpel or similar sharp method removes the tissue without traction. Coders also sometimes miss that harvested graft tissue used elsewhere still generates a separate code for the extraction site itself, distinct from the code for wherever the graft is placed.