ICD-10-PCS Billable Code

0BM40ZZ

Reattachment Upper Lobe Bronchus, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemB Respiratory System
OperationM Reattachment
Body Part4 Upper Lobe Bronchus, Right
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Putting back in or on all or a portion of a separated body part to its normal location or other suitable location

Procedure Overview

Reattachment procedures put a portion of the respiratory system that has been completely separated from the body back into its normal position, restoring its physical connection. In practice this applies to traumatic injuries, such as a severed trachea or bronchus following a severe chest injury, where the surgical team reconnects the separated segment to its original location rather than removing it or replacing it with a graft. This is a less commonly performed procedure than the other respiratory root operations and is generally reserved for significant trauma or iatrogenic transection requiring urgent surgical repair.

Anatomy & Axis Detail

Upper Lobe Bronchus, Right

The right upper lobe bronchus branches from the right main bronchus at a relatively high point and quickly divides into apical, posterior, and anterior segmental airways supplying the uppermost portion of the right lung. Reattachment of this bronchus is generally performed after a sleeve resection removing a centrally located tumor that would otherwise require sacrificing the entire lobe, or following traumatic avulsion, with the goal of restoring airway continuity to lung tissue that can still be preserved. Its short segmental length before further branching limits the room available for a tension-free repair, so precise alignment of the cut ends is emphasized to avoid narrowing at the reattachment site.

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

This code is assigned when the operative note describes reconnecting a body part that had been fully detached, not merely repairing a laceration or partial tear, which would instead be coded as Repair. Documentation needs to clearly establish that the structure was completely separated before the surgeon reattached it, along with the specific respiratory structure involved. A frequent coding pitfall is applying Reattachment to procedures that only involve suturing a partial injury back together, since PCS reserves this root operation strictly for complete separations reconnected to their original site.

Commonly Confused With

RepairReattachment is distinguished from Repair, which addresses partial disruptions like lacerations or incomplete tears using techniques not described by another root operation.
TransplantationIt is also different from Transplantation, which involves putting in a whole or part of a body part from another individual, whereas Reattachment always involves the patient's own previously separated tissue.