0QR93JZ
Replacement Femoral Shaft, Left to No Qualifier with Synthetic Substitute, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | R Replacement |
| Body Part | 9 Femoral Shaft, Left |
| Approach | 3 Percutaneous |
| Device | J Synthetic Substitute |
| Qualifier | Z No Qualifier |
Operation Definition
Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part
Procedure Overview
Replacement procedures put in biological or synthetic material that physically takes over the role of all or part of a lower bone. This includes structural bone grafts, cadaver bone allografts, and synthetic bone substitutes used to rebuild a portion of the pelvis, femur, tibia, fibula, or foot bones after tumor resection, severe trauma, or bone loss from infection.
These procedures are performed when a segment of bone is missing or so damaged that it can no longer support the body's structure or function on its own, and simply repairing or repositioning the remaining bone isn't enough. A patient who has had a tumor removed from the femoral shaft, for example, may need the resulting gap filled with a structural allograft to restore the bone's load-bearing capacity.
Anatomy & Axis Detail
Femoral Shaft, Left
The femoral shaft on the left side is the diaphyseal column connecting the upper and lower femur, bearing axial load and housing the medullary canal. Replacement procedures at this site are reserved for situations where a segment of bone cannot be salvaged, such as primary bone tumor resection, chronic osteomyelitis with sequestrum formation, or a shaft fracture that has failed to unite despite prior fixation. The surgeon substitutes the missing diaphyseal segment with a modular endoprosthesis or structural allograft, anchored by long stems extending into the remaining proximal and distal femoral bone to reestablish a continuous load-bearing column. Because the shaft has no adjacent joint surface of its own, success is measured by restored limb length and rotational alignment rather than joint motion, distinguishing this procedure from hip or knee arthroplasty performed on neighboring segments.
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.
Device: Synthetic Substitute
Synthetic Substitute designates a device made from manufactured, non-biologic material, such as mesh or prosthetic components, used to replace or augment a body part. It is distinguished from the two tissue substitute categories by its artificial composition, which carries different considerations for integration and long-term durability than biologic grafts.
Coding & Documentation
Documentation must describe material being put in that takes over the physical role of the bone segment - not material that merely reinforces existing bone, which would be Supplement instead. The type of graft or substitute material and the specific bone segment addressed both need to be clear in the operative note. A frequent error is coding Replacement when bone graft is used to fill a defect but the native bone structure is still largely intact and functional, which points toward Supplement rather than Replacement; another is confusing joint replacement procedures, which are coded to the Lower Joints body system, with bone-segment replacement coded here.