ICD-10-PCS Billable Code

0QNC3ZZ

Release Lower Femur, Left to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
OperationN Release
Body PartC Lower Femur, Left
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Freeing a body part from an abnormal physical constraint by cutting or by the use of force

Procedure Overview

Release procedures on the lower bones free a bone from something abnormal that is pressing on it, wrapping around it, or holding it in an unnatural position, without cutting into or removing any of the bone itself. The most common example is releasing a nerve or blood vessel that has become trapped by scar tissue, a thickened ligament, or a healed fracture fragment in the pelvis, femur, tibia, fibula, or foot bones. Another frequent scenario is cutting through a fibrous or bony bridge that has fused across a joint space, such as a tarsal coalition in the foot that keeps two bones from moving independently.

These operations are performed to relieve pain, restore movement, or stop ongoing nerve damage. A child with a congenital tarsal coalition may need the abnormal bridge divided so the foot can move normally; an adult with post-traumatic scarring around the fibula may need the area cleared to relieve nerve compression. The bone's own shape is left essentially unchanged - only the constraining tissue is addressed.

Anatomy & Axis Detail

Lower Femur, Left

In the left lower femur, the flared metaphyseal and condylar region sits directly above the knee and provides broad attachment for the collateral ligaments and joint capsule, making it prone to adhesion formation after distal femur fracture, total knee arthroplasty, or extended casting. These adherent bands can anchor the capsule to the condylar surface and restrict knee motion even after the underlying injury has healed. Release frees this periarticular scar tissue from the bone without removing condylar surface or changing femoral alignment. Because the popliteal vessels and tibial nerve pass just posterior to this region, the dissection plane is deliberately conservative, and the procedure is coded separately from any ligament repair or component revision addressed in the same setting.

Approach: Percutaneous

Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.

Coding & Documentation

The coder needs documentation naming the specific bone being freed and clearly identifying what is doing the constraining - scar, adhesion, coalition, or an entrapping band. Operative notes should state that the surrounding restrictive tissue was divided or excised and that the bone itself was not resected or reshaped. A frequent assignment error is defaulting to Division when a true anatomic obstruction is present; Release is used when the goal is freeing the part from something abnormal, while Division applies to cutting into the bone itself without addressing a separate constraining structure. Coders also sometimes miss that the body part value should reflect the bone being released, not the tissue that was cut away.

Commonly Confused With

DivisionDivision is the closest source of confusion, since both can involve cutting bone-adjacent tissue; the distinction is whether an outside constraint is being removed (Release) versus the bone itself being separated with no restraining structure present (Division).
RepairRepair is sometimes miscoded when a release is combined with closure of the surrounding soft tissue; only the release portion, if it is the objective of the procedure, is coded to this root operation.