07QL3ZZ
Repair Cisterna Chyli to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | Q Repair |
| Body Part | L Cisterna Chyli |
| Approach | 3 Percutaneous |
| 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 in this body system is the catch-all corrective procedure used when a lymphatic or hemic structure - most often the spleen, but also lymph nodes, the thymus, or the thoracic duct - has been damaged and needs to be restored to as close to normal anatomy and function as possible, using a technique that does not fit any more specific root operation. A classic example is suturing a lacerated spleen after blunt trauma, sometimes called splenorrhaphy, to control bleeding while preserving the organ rather than removing it. Another is closing a lymphatic fistula or leak, such as a chyle leak from an injured thoracic duct.
These procedures matter clinically because they aim to save the organ or vessel and its function, which for the spleen in particular helps preserve immune defenses that would be lost with removal.
Anatomy & Axis Detail
Cisterna Chyli
The cisterna chyli is a dilated lymphatic sac situated in the retroperitoneum near the second lumbar vertebra, where lymph from the lower limbs, pelvis, and abdominal viscera collects before ascending as the thoracic duct. Repair of this structure is rare and generally follows injury during retroperitoneal, aortic, or spinal surgery in that region, where its thin wall can be torn and produce a chylous leak or ascites. Its deep location adjacent to the aorta, vertebral bodies, and lumbar vessels makes both the original injury and the subsequent repair technically demanding, often requiring careful exposure to visualize the defect. Documentation should confirm the cisterna chyli itself, rather than an adjacent lumbar or mesenteric lymphatic trunk, is the structure being restored, since these are coded to different 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
Repair is a default root operation, so coders should only assign it after ruling out that the documented technique matches one of the more specific root operations - Release, Reposition, Resection, or a reconstructive operation like Replacement or Supplement. If the note describes suturing a spleen laceration with no other technique implied, Repair is appropriate; if it describes removing damaged splenic tissue along with the repair, part of the procedure may need to be coded as Excision instead. A common documentation gap is a vague operative note that says "repaired" without describing what was actually done, forcing the coder to query the physician rather than guess. Coders should also verify the correct body part, since a thoracic duct repair and a splenic repair use different values.