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Repair Acromioclavicular Joint, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | R Upper Joints |
| Operation | Q Repair |
| Body Part | G Acromioclavicular Joint, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Restoring, to the extent possible, a body part to its normal anatomic structure and function
Procedure Overview
Repair procedures on the upper joints restore a joint structure to as close to its normal anatomy and function as possible when it has been damaged by injury or disease, using a method that does not fit any more specific root operation. This is a broad, catch-all category within the joints body system and commonly applies to procedures such as suturing a torn joint capsule, repairing a labral tear in the shoulder that does not involve a graft, or fixing a traumatic joint injury that does not call for excision, replacement, or reconstruction techniques.
Because so many joint conditions have a dedicated, more specific root operation, true Repair codes in this family tend to represent procedures that genuinely fall outside those categories, such as closure of an open joint wound or a straightforward suture repair of a torn structure.
Anatomy & Axis Detail
Acromioclavicular Joint, Right
The right acromioclavicular joint links the lateral clavicle to the acromion of the scapula and depends heavily on the acromioclavicular and coracoclavicular ligaments for stability. Repair is typically performed after a shoulder separation injury in which these ligaments are stretched or torn but the joint surfaces remain otherwise intact, so the procedure focuses on suturing or reattaching the native ligamentous and capsular structures rather than replacing tissue. Documentation should distinguish this ligament-focused restoration from procedures that use grafts or synthetic material to reconstruct the coracoclavicular support, which would instead be coded as a different root operation. Because the joint is subcutaneous and easily palpated, surgeons can assess reduction directly during closure, and postoperative alignment of the clavicle relative to the acromion is a key marker of an adequately restored joint.
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.
Coding & Documentation
This root operation should only be assigned when no other root operation more precisely describes what was done - PCS coding conventions treat Repair as the default when a documented procedure does not meet the definition of any other root operation for that body part. The operative note needs to specify the anatomic structure repaired and the technique used, such as suture, in enough detail to rule out a more specific code.
The most frequent error is defaulting to Repair too quickly instead of checking whether the documented technique actually matches a more specific root operation like Reattachment, Reposition, or Supplement - for example, a labral repair reinforced with an anchor and graft material may actually qualify as Supplement rather than plain Repair. Coders should also confirm the repair was not performed as an incidental step of a more extensive procedure on the same joint, in which case it may not be separately reportable.