0BDM4ZX
Extraction Lungs, Bilateral to Diagnostic with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | B Respiratory System |
| Operation | D Extraction |
| Body Part | M Lungs, Bilateral |
| Approach | 4 Percutaneous Endoscopic |
| 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 the respiratory system involves pulling or stripping tissue or material out using force rather than cutting, a less common approach than excision but used when a structure is removed by traction alone. This might apply to removal of an object or tissue by grasping and pulling it free without dissecting or cutting through surrounding structures, as documented by the operating physician.
Anatomy & Axis Detail
Lungs, Bilateral
Bilateral lung extraction denotes removal of obstructing solid matter, such as extensive mucus plugging, aspirated material, or blood clots, from both lungs during the same operative episode, generally in critically ill or intubated patients with diffuse airway compromise. This is distinct from separately coding two unilateral procedures and applies when documentation supports a single bilateral intervention, typically flexible bronchoscopy performed sequentially through each mainstem bronchus and its branches. Bilateral involvement often accompanies severe pneumonia, near-drowning, or massive aspiration events where debris is not confined to one side. Because both lungs are addressed, the procedure may take considerably longer and require re-scoping to confirm clearance on each side. Documentation should clearly indicate bilateral extraction rather than staged unilateral procedures performed on different dates, which would be coded separately.
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.
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
Because Extraction is defined specifically by the absence of cutting, coders need explicit documentation that the material was pulled, stripped, or avulsed rather than excised, since the two root operations lead to different codes even when the clinical scenario looks similar on the surface. It's one of the less frequently used root operations in this body system, so coders should double check the operative note's verbs (pulled, stripped, avulsed) rather than defaulting to Excision out of habit whenever tissue is taken out.