ICD-10-PCS Billable Code

0LDM0ZZ

Extraction Upper Leg Tendon, Left to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemL Tendons
OperationD Extraction
Body PartM Upper Leg Tendon, Left
Approach0 Open
DeviceZ No Device
QualifierZ 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

Upper Leg Tendon, Left

On the left, the upper leg tendons encompass the quadriceps and hamstring tendon groups along with tendinous fibers of the iliotibial tract, all of which support the substantial forces generated during hip and knee motion. Extraction in this region addresses retained foreign objects, for instance following a penetrating thigh injury, or the need to biopsy a soft tissue mass associated with one of these tendons, such as a lesion near the semitendinosus or rectus femoris insertion. Given the size and load-bearing function of thigh tendons, the surgeon must extract matter without weakening the tendon's fibers or destabilizing its attachment to bone. Because multiple named tendons occupy the thigh, precise identification of the specific tendon and its left-sided laterality is essential for accurate clinical documentation.

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.

Commonly Confused With

ExcisionExcision is the closest source of confusion, since both remove tendon tissue; the deciding factor is technique - cutting away with a sharp instrument is excision, while pulling or stripping the tissue out is extraction.
ResectionResection is ruled out because that root operation requires removal of an entire body part, and tendons are not coded as discrete whole-body-part units in the way an organ would be.
DetachmentDetachment is a separate consideration when an extremity or limb portion is being cut off along with its tendons, which is not the case in a straightforward graft harvest.