0MDG3ZZ
Extraction Rib(s) Bursa and Ligament to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | D Extraction |
| Body Part | G Rib(s) Bursa and Ligament |
| Approach | 3 Percutaneous |
| 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 procedures pull or strip out all or part of a bursa or ligament using force, rather than by cutting. This root operation is used less often for bursae and ligaments than for structures like veins, but it applies when tissue is physically stripped away, for example when a scarred or adhered portion of a ligament is forcibly separated from surrounding structures during surgical mobilization.
Because the defining feature is force rather than sharp dissection, these procedures are typically reserved for situations where a structure is being avulsed or stripped rather than incised, such as forcibly detaching adherent tissue during a difficult revision procedure.
Extraction is chosen based on the surgical technique actually used, not the underlying condition, so the same clinical problem might be addressed with excision in one case and extraction in another depending on how the surgeon physically removed the tissue.
Anatomy & Axis Detail
Rib(s) Bursa and Ligament
The rib(s) bursa and ligament body part refers to the ligamentous connections stabilizing the ribs, including costotransverse and costovertebral ligaments and any associated bursal tissue. Extraction is used when calcified material, a loose fragment, or cystic contents are pulled or cut free from within these ligaments without removing the ligament structure itself, which can occur in cases of calcific bursitis or degenerative changes at the costovertebral junctions. Because the ribs articulate with the thoracic vertebrae and encircle the thoracic cavity, procedures here require care to avoid the adjacent pleura and intercostal neurovascular bundle. This code applies regardless of which or how many ribs are involved, since ICD-10-PCS does not differentiate rib level or laterality for this body part value.
Approach: Percutaneous
Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.
Coding & Documentation
Coders should look specifically for language describing pulling, stripping, or avulsing tissue by force, as opposed to cutting it with an instrument. This distinction can be subtle in operative notes, so close reading of the technique description is essential rather than assuming based on the diagnosis alone.
A common error is defaulting to Excision for any tissue removal without verifying whether the surgeon actually used a cutting instrument or physically stripped the tissue free, since these map to different root operations. Extraction is also uncommon enough in this body system that coders should double check the guidance and any coding clinic advice before assigning it.