0SPKX0Z
Removal Tarsometatarsal Joint, Right to No Qualifier with Drainage Device, External Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | S Lower Joints |
| Operation | P Removal |
| Body Part | K Tarsometatarsal Joint, Right |
| Approach | X External |
| Device | 0 Drainage 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 a lower joint, such as internal fixation hardware, a spacer, drainage tubing, or an external fixator frame. These procedures are performed once the device has served its purpose - for example, after a fracture has healed and screws are no longer needed - or when a device is causing pain, infection, or mechanical irritation and needs to come out. Removal can be a planned, staged part of treatment or an unplanned procedure prompted by a complication.
Because the device itself, not the joint tissue, is the focus, these procedures are typically less extensive than the original surgery that placed the device, though scar tissue and bony ingrowth around older hardware can make removal technically demanding.
Anatomy & Axis Detail
Tarsometatarsal Joint, Right
The right tarsometatarsal joints, known collectively as the Lisfranc complex, connect the cuneiforms and cuboid to the bases of the metatarsals and are essential to the rigidity of the midfoot arch during push-off. This joint frequently receives screws or plates after Lisfranc fracture-dislocation repair or midfoot fusion for arthritis, and those implants are later removed once the ligamentous and osseous structures have stabilized. Retained hardware across this joint can restrict the small but functionally important gliding motion of the midfoot or cause pain with shoe wear over the dorsal foot. Because the Lisfranc joint is prone to painful nonunion or malalignment if healing is incomplete, surgeons confirm radiographic union before removal and document the specific tarsometatarsal ray involved.
Approach: External
External approach applies to procedures performed directly on the skin or mucous membrane, or on an accessible body surface, without any instrumentation passing through a puncture or orifice. It covers things like manual reduction of a fracture or excision of a skin lesion. It differs from Via Natural or Artificial Opening in that no internal passage is entered at all, only the exposed surface.
Device: Drainage Device
Drainage Device denotes a device such as a tube or catheter left in place to remove fluid, blood, or air from a body part or cavity following a procedure. It is distinguished from Monitoring Device, which senses and records physiologic data rather than evacuating substances from the body.
Coding & Documentation
The operative note must identify the specific device being taken out and confirm nothing is being put in its place; if a new device replaces the old one, the more specific combination root operation (such as Revision) may apply instead of a plain Removal. The body part coded is the joint from which the device is taken, using the device's original insertion site. A recurring error is coding Removal when hardware is being exchanged for a different device during the same procedure, which should instead be captured as Revision, or when the device is being taken out specifically because it failed, which some coders mistakenly still classify simply as Removal without checking whether Revision criteria are met.