0QPC35Z
Removal Lower Femur, Left to No Qualifier with External Fixation Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | P Removal |
| Body Part | C Lower Femur, Left |
| Approach | 3 Percutaneous |
| Device | 5 External Fixation Device |
| 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
Lower Femur, Left
The left lower femur, comprising the distal condylar and metaphyseal region above the knee, often retains plates or intramedullary devices placed for supracondylar femoral fractures or distal reconstructive procedures. Removal describes extracting this previously implanted hardware, typically indicated after fracture union, when the implant irritates surrounding soft tissue near the knee, or when infection mandates its removal. Because this area sits directly adjacent to the knee joint, popliteal neurovascular structures, and the distal quadriceps and patellar tendon attachments, extraction requires precise surgical technique to protect these structures while accessing the hardware. Documentation should specify laterality and identify the device taken out, keeping the procedure distinct from any bone resection or joint-related intervention performed in the same operative episode, which would be captured under a separate root operation.
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.
Device: External Fixation Device
This is the general external fixation device value, used when pins or wires anchored in bone are connected to a stabilizing frame outside the body to hold a fracture or joint in position, without specifying a more particular frame configuration. It contrasts with the more specific External Fixation Device subtypes - Monoplanar, Ring, Hybrid, and Limb Lengthening - which describe the frame's geometry or added lengthening function.
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.