ICD-10-PCS Billable Code

0PQ33ZZ

Repair Cervical Vertebra to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemP Upper Bones
OperationQ Repair
Body Part3 Cervical Vertebra
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Restoring, to the extent possible, a body part to its normal anatomic structure and function

Procedure Overview

This family covers surgical repair of the bones of the skull, face, ribs, sternum, and upper limbs - the clavicle, scapula, humerus, radius, ulna, and the small bones of the wrist and hand - when a fracture, crack, or other structural defect needs to be fixed but doesn't fit a more specific repair category like reposition or replacement. A surgeon might use this approach for a depressed skull fracture, a cracked sternum, a small chip fracture in a carpal bone, or a rib that needs stabilization after trauma.

The underlying goal is simply to restore the bone to something close to its normal shape and strength, using whatever technique the situation calls for - wiring, plating, bone grafting, or direct suturing of periosteum. It's often the option coders reach for when nothing else in the root operation list quite matches what the operative note describes, since it functions as the default "fix it" category for bones.

Anatomy & Axis Detail

Cervical Vertebra

The seven cervical vertebrae form the most mobile portion of the spine, carrying the weight of the skull while surrounding and protecting the spinal cord and the vertebral arteries that pass through openings in the transverse processes. Repair applies when a fractured vertebral body, lamina, pedicle, or spinous process is restored to its normal contour and alignment without fusing it to an adjacent segment or implanting hardware for stabilization, as might occur with reduction of a minor compression fracture or closure of a bony defect. Given how little space surrounds the cervical cord, even modest bony injury here carries meaningful neurologic risk, so operative notes should distinguish work on the vertebral bone itself from procedures on the disc, ligaments, or facet joints, which are captured under separate body part values.

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.

Coding & Documentation

A coder assigns from this family when the operative note describes correcting a bone defect without moving a displaced fragment back into alignment (that's reposition) or removing and replacing tissue (that's replacement or supplement). Documentation should specify the exact bone and any device or graft material used, since that affects the qualifier and device value. The most common assignment error is defaulting to repair when the surgeon actually performed a reposition of a displaced fracture fragment - the two are frequently confused because both involve fractures. Another frequent mistake is coding repair when a bone graft was used to reinforce rather than restore the bone, which should instead be captured as supplement.

Commonly Confused With

RepositionReposition is the closest look-alike: it applies when a displaced or malpositioned bone fragment is moved back to its correct location, while repair is reserved for defects that don't involve moving a fragment.
SupplementSupplement is also easily confused since bone grafting can appear in both - if graft material reinforces an intact structure rather than fixing a defect, supplement is correct instead.