01DA4ZZ
Extraction Lumbosacral Plexus to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 1 Peripheral Nervous System |
| Operation | D Extraction |
| Body Part | A Lumbosacral Plexus |
| Approach | 4 Percutaneous Endoscopic |
| 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
This family covers the forcible pulling or stripping of all or part of a peripheral nerve, most commonly seen in procedures like nerve stripping for certain chronic pain conditions or the mechanical avulsion of a nerve segment. It is a less common operation in this body system than in others, since peripheral nerves are usually cut or dissected free rather than pulled out under force.
When it is performed, the intent is typically to eliminate a nerve's function entirely by physically removing it through traction rather than sharp dissection, often for a nerve that is already damaged beyond repair or is the source of persistent, difficult-to-treat pain.
Anatomy & Axis Detail
Lumbosacral Plexus
The lumbosacral plexus, formed where the lumbar plexus contributions join the sacral plexus via the lumbosacral trunk, spans the pelvic brim and supplies the entirety of lower limb innervation. Extraction of material from this junctional network typically follows pelvic trauma, complex spine or pelvic hardware placement, or obstetric injury where a foreign object such as bone fragment, mesh material, or broken instrument tip has become lodged at the trunk's crossing point. Its location straddling the sacroiliac region and psoas muscle makes surgical access technically demanding, often requiring a combined retroperitoneal exposure to reach the full extent of the trunk. This code applies specifically when the object spans or sits at the union of the two plexuses rather than being confined to one, which would instead be coded to that individual plexus.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Coding & Documentation
This code is used only when the documentation specifically describes force, such as pulling or stripping, being used to remove the nerve or a portion of it, rather than a scalpel or cautery cutting it free. Because this method is uncommon for peripheral nerves, coders should read the operative note carefully to confirm the technique actually matches Extraction and was not simply described loosely by the surgeon when a standard excision was performed. Vein stripping terminology from vascular procedures is sometimes mistakenly carried over to nerve cases, leading to incorrect code selection when the actual technique was sharp dissection.