0QRB07Z
Replacement Lower Femur, 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 | B Lower Femur, 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
Lower Femur, Right
The lower femur encompasses the medial and lateral femoral condyles and the metaphyseal flare that articulates with the tibia and patella to form the knee joint. Replacement of this region describes the femoral component of total or partial knee arthroplasty, in which arthritic or destroyed condylar surfaces are resected and resurfaced with a contoured metal implant that recreates the rolling and gliding motion of normal knee flexion. Indications include end-stage osteoarthritis, rheumatoid destruction, post-traumatic arthritis, or revision of a failed prior implant. Because the distal femur must align precisely with the mechanical axis of the limb, intraoperative instrumentation is used to set rotational and coronal alignment before the implant is fixed with cement or a press-fit, and documentation should note whether the tibial and patellar components were addressed as separate procedures.
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.