0MHY4YZ
Insertion Lower Bursa and Ligament to No Qualifier with Other Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | H Insertion |
| Body Part | Y Lower Bursa and Ligament |
| Approach | 4 Percutaneous Endoscopic |
| Device | Y Other Device |
| Qualifier | Z 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
This family covers placing a nonbiological device into a bursa or ligament to support or protect the structure, without replacing any of the patient's own tissue. The most common example is a synthetic augmentation device threaded alongside a repaired or reconstructed ligament to share load while the body's own healing takes over, though the same root operation also captures placement of markers, spacers, or other appliances left in bursal or ligamentous tissue for a defined purpose.
Surgeons choose this approach when native tissue alone is judged too weak, too damaged, or too slow-healing to hold up under normal stress right away. A knee or shoulder ligament repair, for instance, may be reinforced with an internal brace so the joint can bear more activity during recovery rather than waiting months for the graft to mature on its own.
Because nothing is being replaced, the device is meant to work with the existing anatomy, and it can often stay in place indefinitely or be removed later once it has served its purpose.
Anatomy & Axis Detail
Lower Bursa and Ligament
Insertion into lower bursa and ligament structures covers devices placed within tissues such as the hip's iliofemoral ligament region, the knee's collateral or cruciate-adjacent ligaments, or bursae like the prepatellar or trochanteric sacs, without repairing existing damage. Typical applications include implanting a drug-infusion catheter into an inflamed bursa for localized pain control after joint surgery, or positioning a spacer device to offload a chronically irritated ligament-bursa interface. Because lower extremity ligaments bear substantial weight-bearing and rotational stress, device placement must account for the mechanical loads the structure will continue to experience postoperatively. As with the upper body counterpart, precise identification of the specific bursa or ligament receiving the device is essential, particularly around the hip and knee where multiple bursae lie in close proximity.
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.
Device: Other Device
Other Device is a catchall value used when a device remains in place but does not fit any of the specifically defined categories, such as tissue substitutes, drainage tubes, radioactive elements, or monitoring sensors. It allows coding of implanted or inserted devices that fall outside those named classifications.
Coding & Documentation
Assignment depends on documentation clearly stating that a device was placed to monitor, assist, or protect a bursa or ligament, with no biological material being substituted for the patient's own tissue. Operative notes should name the specific device type (anchor, augmentation tape, internal brace) and confirm it was left in the body rather than used only as a temporary surgical aid.
The error coders run into most often is confusing Insertion with Supplement, since both can appear in the same operative report when a ligament is repaired and reinforced at once. If the device only reinforces existing tissue without adding biological or synthetic material that becomes part of the structure itself, Insertion is correct; if graft material is being put in to reinforce or replace tissue, Supplement applies instead. Coders also sometimes miss that Insertion is reported separately from a concurrent Repair or Reconstruction, since ICD-10-PCS treats the device placement as its own distinct procedure step.