0QP40KZ
Removal Acetabulum, Right to No Qualifier with Nonautologous Tissue Substitute, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | P Removal |
| Body Part | 4 Acetabulum, Right |
| Approach | 0 Open |
| Device | K Nonautologous Tissue Substitute |
| Qualifier | Z No Qualifier |
Operation Definition
Taking out or off a device from a body part
Procedure Overview
Removal procedures take out a device that was previously placed in or on a lower bone - hardware such as plates, screws, rods, pins, external fixator components, or spacers used in the pelvis, femur, tibia, fibula, patella, or foot bones. These devices are typically inserted to stabilize a fracture, hold a bone graft, or support a joint during healing, and removal happens once that purpose has been served or if the device is causing a problem.
Reasons for removal vary widely. Hardware may simply be scheduled for extraction after a fracture has healed, especially in children whose growing bones can be irritated by permanent implants. In other cases the device is removed because it has become infected, has loosened, is causing pain from irritating overlying soft tissue, or is interfering with a later procedure such as a joint replacement.
Anatomy & Axis Detail
Acetabulum, Right
The right acetabulum is the cup-shaped socket of the pelvis that articulates with the femoral head to form the hip joint, and it commonly holds screws, cages, or augment hardware placed during acetabular fracture fixation or revision hip arthroplasty. Removal here refers to extracting that previously placed device, a step often needed when converting to total hip replacement, when hardware impinges on the joint, or when an infected implant must come out before reconstruction. Because the acetabulum sits at the convergence of weight-bearing forces and lies near the sciatic nerve and pelvic vasculature, removing embedded hardware requires precise localization, sometimes guided by prior imaging of screw trajectories. Documentation should note laterality and the type of device extracted, keeping this distinct from any reaming or bone resection performed in the same setting.
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: Nonautologous Tissue Substitute
Nonautologous Tissue Substitute refers to biologic material sourced from a donor or another species, such as an allograft or xenograft, used to replace a body part. It differs from Autologous Tissue Substitute by tissue origin outside the patient's own body, and from Synthetic Substitute by being biologic rather than manufactured material.
Coding & Documentation
Coders assign Removal when documentation confirms a device is being taken out and not replaced with another device during the same operative episode - if a new device goes in at the same site, the procedure is Change or a combination of Removal and another root operation such as Insertion, not Removal alone. The device type and the specific bone it was removed from both need to be identifiable from the operative note. A common error is coding Removal for hardware that is only being adjusted or repositioned rather than fully extracted, or overlooking that the removal of a device is bundled into a broader procedure when substantial additional work, like bone repair, is performed at the same site.