0QR807Z
Replacement Femoral Shaft, Right to No Qualifier with Autologous Tissue Substitute, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | R Replacement |
| Body Part | 8 Femoral Shaft, Right |
| Approach | 0 Open |
| Device | 7 Autologous Tissue 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, Right
The femoral shaft is the long diaphyseal segment between the upper and lower femur, a weight-bearing column of dense cortical bone that also serves as the insertion site for the intramedullary canal used in many stabilization devices. True replacement of this segment is uncommon and generally reserved for extensive segmental bone loss from tumor resection, severe comminuted fracture nonunion, or infection requiring removal of a large diaphyseal block, after which a custom or modular endoprosthetic spacer or allograft-prosthetic composite restores structural continuity. Because the shaft bridges two joints, the replacement device must match native length and rotational alignment closely to avoid altering knee and hip mechanics, and fixation typically relies on long intramedullary stems cemented or press-fit into the residual proximal and distal femoral bone.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Device: Autologous Tissue Substitute
Autologous Tissue Substitute identifies a device value where material harvested from the patient's own body, such as an autograft, is used to replace or reconstruct a body part. Its defining feature is tissue origin from the patient, setting it apart from Nonautologous Tissue Substitute, sourced from a donor or animal, and Synthetic Substitute, made of manufactured material.
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.