0PR74JZ
Replacement Glenoid Cavity, Right to No Qualifier with Synthetic Substitute, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | P Upper Bones |
| Operation | R Replacement |
| Body Part | 7 Glenoid Cavity, Right |
| Approach | 4 Percutaneous Endoscopic |
| 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 in the upper bones involve removing all or part of a bone in the skull, face, thorax, or upper limb and substituting it with a device or biological material that takes over its structural role. Cranioplasty with a synthetic plate after a skull defect, and prosthetic reconstruction of a portion of the humerus or clavicle following tumor removal, are typical examples.
These procedures are performed when a bone is too damaged, diseased, or absent to be repaired or repositioned, and the patient needs a physical substitute to maintain the shape of the skull or the mechanical function of a limb. The material can be a synthetic implant, such as titanium mesh or bone cement, or biological tissue, such as an allograft.
Anatomy & Axis Detail
Glenoid Cavity, Right
The glenoid cavity is the shallow, pear-shaped articular surface on the lateral scapula that receives the humeral head, and its bone stock is what determines whether a shoulder reconstruction will hold over time. Replacement of this specific structure is most often performed for severe glenoid bone loss from erosive arthritis, recurrent instability, or failed prior arthroplasty, where a bone graft or augmented glenoid component is used to rebuild the socket before any prosthetic articulation is attached. Because the glenoid is thin and cancellous, achieving adequate purchase for fixation is often the technical crux of the case. Documentation should distinguish glenoid bone replacement from replacement of the scapular body proper, as ICD-10-PCS tracks them as distinct anatomic targets.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
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
Coding from this family requires documentation that a body part was actually taken out and something physically put in its place, not simply reinforced. The device value must match the material used - synthetic versus autologous versus nonautologous tissue - so operative notes describing the graft source matter for accurate code selection. A recurring error is coding replacement when the native bone was left in place and only augmented, which belongs under supplement instead. Coders should also confirm whether the replaced segment is a full bone or only a portion, since this affects the body part value chosen.