ICD-10-PCS Billable Code

0QH806Z

Insertion Femoral Shaft, Right to No Qualifier with Internal Fixation Device, Intramedullary, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
OperationH Insertion
Body Part8 Femoral Shaft, Right
Approach0 Open
Device6 Internal Fixation Device, Intramedullary
QualifierZ No Qualifier

Operation Definition

Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part

Procedure Overview

Insertion procedures place a nonbiological device into a lower bone to monitor, assist, or support it, without taking the place of any bone tissue. Common examples include implanting a bone growth stimulator, placing radiographic markers, or inserting fixation hardware such as pins or screws for stabilization when no fracture is being actively repaired at that session.

These devices support healing or diagnosis over time rather than immediately fixing a structural problem, so patients often keep them in place for weeks or months, with follow-up imaging or visits to track progress.

Anatomy & Axis Detail

Femoral Shaft, Right

The right femoral shaft is the long diaphyseal segment of the thighbone between the proximal and distal metaphyses, a common site for intramedullary rod placement when insertion is used to describe a device left in the canal without accompanying fracture reduction. This body part is notable for its thick cortical bone and central medullary cavity, which can accommodate rods, stimulators, or radioactive sources placed for therapeutic purposes such as promoting union in a nonunion or delivering localized treatment. Because the shaft is the most common site of femoral fracture from high-energy trauma, coders must differentiate insertion of a stabilizing or monitoring device from the fixation and reduction procedures typically documented alongside diaphyseal fracture repair, which fall under different root operations.

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.

Device: Internal Fixation Device, Intramedullary

An intramedullary internal fixation device is a rod or nail inserted into the medullary canal of a long bone to stabilize a fracture from within, sharing load along the bone's central axis. It is distinguished from a rigid plate, which stabilizes the bone from its outer surface, and from the intramedullary limb lengthening variant, which adds a mechanism to gradually distract the bone.

Coding & Documentation

This code family applies when a device is put into the bone and nothing about the bone itself is being cut, repaired, or realigned in that same procedure. Documentation should name the specific device and confirm it isn't replacing a body part. A frequent misstep is coding insertion when hardware is placed during an active fracture reduction or fusion - in those cases the device placement is typically captured within the reduction or fusion code rather than as a separate insertion, and coding both can result in overcoding. Insertion is coded separately when the device placement is the entire purpose of the encounter, such as a later-stage stimulator implant.

Commonly Confused With

Insertion is most often confused with Replacement, which physically substitutes for bone tissue (such as a joint prosthesis) rather than simply adding a device alongside it, and with the device-placement component bundled into Reposition or Fusion procedures, where hardware is incidental to the primary root operation rather than the reason for the encounter.