0MHX0YZ
Insertion Upper Bursa and Ligament to No Qualifier with Other Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | H Insertion |
| Body Part | X Upper Bursa and Ligament |
| Approach | 0 Open |
| 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
Upper Bursa and Ligament
Insertion procedures on upper bursa and ligament structures place a device into tissues such as the shoulder's subacromial bursa, glenohumeral ligaments, elbow's ulnar or radial collateral ligaments, or wrist ligamentous complexes, without repairing or altering the underlying anatomy. A common example is placing a subacromial balloon spacer to manage an irreparable rotator cuff tear, or positioning a suture anchor or drug-delivery device such as a pain pump catheter into the bursal space after shoulder surgery. Because the upper extremity relies on a dense network of stabilizing ligaments across highly mobile joints, the inserted device must be sized and positioned to avoid restricting normal range of motion. Documentation should specify the device type and the exact bursa or ligament into which it was placed, since the same joint region often has multiple candidate sites.
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: 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.