0UP343Z
Removal Ovary to No Qualifier with Infusion Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | P Removal |
| Body Part | 3 Ovary |
| Approach | 4 Percutaneous Endoscopic |
| Device | 3 Infusion 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 female reproductive organ, rather than treating the organ or tissue itself. Common examples include removing an intrauterine device, a pessary used for prolapse support, a vaginal packing or drain, or a surgical mesh or sling material used in prior reconstructive surgery. The organ housing the device is not being treated for disease during this procedure; the focus is solely on extracting the implanted or inserted material.
Patients encounter this family of procedures for many reasons - an IUD reaching the end of its approved lifespan, a device causing discomfort or complications, or a temporary object like packing that was always meant to come out after a set period. Depending on the device and how it was originally placed, removal can be a simple office procedure or require a return trip to the operating room, particularly if the device has become embedded or scarred into surrounding tissue.
Anatomy & Axis Detail
Ovary
The ovary is the paired gonadal organ responsible for oocyte production and cyclic hormone secretion, and Removal as a root operation applies when an entire ovary that has already been taken out of the body, whether during a prior operative step or as a specimen awaiting further handling, is physically taken out of the patient in this encounter. In practice this code is most often used for taking out a device or a foreign object previously placed in or near the ovary, such as a mesh, clip, or fixation device, rather than for the excision of ovarian tissue itself, which is coded separately as resection or excision. Documentation should make clear whether native ovarian tissue was excised, which would change the root operation, or whether the procedure was limited to retrieving material without cutting out the gland.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Device: Infusion Device
Infusion Device denotes a device left in place to deliver medication, fluids, or other substances into a body part over time, such as an intrathecal or epidural pump. It is distinct from devices that merely monitor or mechanically support tissue, since its function is ongoing pharmacologic or fluid delivery rather than structural replacement. Common placements include the spinal canal, peritoneal cavity, and vascular access sites.
Coding & Documentation
This root operation is coded when a device is taken out and nothing is put in its place during that same encounter; documentation should identify the specific device removed and confirm no new device was inserted, since a simultaneous removal and replacement is captured differently. Coders need to verify the device type against the correct device value, distinguishing, for instance, an IUD from a pessary from mesh, as each has its own qualifying detail. A frequent error is coding Removal alone when a device is taken out and immediately replaced with a new one in the same session, which instead calls for a distinct combination of Removal and Insertion, or in some code sets a single replacement concept; another is overlooking Removal entirely when it happens incidentally during a different primary procedure, such as taking out an IUD before a hysteroscopy.