07Q68ZZ
Repair Lymphatic, Left Axillary to No Qualifier with No Device, Via Natural or Artificial Opening Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | Q Repair |
| Body Part | 6 Lymphatic, Left Axillary |
| Approach | 8 Via Natural or Artificial Opening 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 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
Lymphatic, Left Axillary
The left axillary lymph nodes sit in the fat and connective tissue of the armpit, draining the left upper limb, chest wall, and lateral breast tissue. Repair here addresses a disrupted node or channel from trauma, iatrogenic injury during breast or axillary surgery, or a fistula, restoring the anatomy without resecting node tissue or diverting flow. Because these nodes lie close to the axillary vessels, brachial plexus, and thoracodorsal and long thoracic nerves, the surgeon must protect these structures while closing a capsule tear or repairing a damaged lymphatic vessel. Documentation should distinguish this restorative repair from excision, destruction, or a bypass procedure, and coders should confirm laterality is left rather than right, since axillary lymphatic injury and subsequent repair often follow breast cancer staging or reconstructive procedures on that same side.
Approach: Via Natural or Artificial Opening Endoscopic
Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.
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.