0QR24JZ
Replacement Pelvic Bone, Right to No Qualifier with Synthetic Substitute, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | R Replacement |
| Body Part | 2 Pelvic Bone, 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 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
Pelvic Bone, Right
The right pelvic bone, comprising the ilium, ischium, and pubis fused around the acetabulum, forms half of the bony pelvic ring and anchors the hip joint along with major muscle attachments for the trunk and thigh. Replacement of this body part occurs when extensive bone loss from tumor resection, severe comminuted fracture, or failed prior reconstruction requires substituting a structural or custom implant for the native pelvic bone, distinct from acetabular component replacement performed during routine hip arthroplasty. Given the pelvis's proximity to major vessels and the lumbosacral plexus, these reconstructions are typically extensive, and documentation should make clear whether the replaced segment is the pelvic bone itself rather than the acetabulum, which is coded separately.
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
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.