0NR507Z
Replacement Temporal Bone, Right to No Qualifier with Autologous Tissue Substitute, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | N Head and Facial Bones |
| Operation | R Replacement |
| Body Part | 5 Temporal Bone, 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 - such as a cranioplasty plate, custom facial implant, or bone graft - to physically take the place of all or part of a skull or facial bone that is missing, damaged, or was previously removed. This family is used when the goal is not just to fix the existing bone but to substitute new material for a portion that no longer serves its structural role.
Common reasons include reconstructing a skull defect left after a craniectomy for trauma or tumor, rebuilding an orbital floor after a blowout fracture, or restoring facial contour with a custom implant following cancer resection. Patients pursuing these procedures are typically working toward both functional protection of underlying structures, like the brain or eye, and restoration of facial appearance.
Anatomy & Axis Detail
Temporal Bone, Right
The right temporal bone is one of the most anatomically complex bones in the skull, housing the middle and inner ear structures, part of the facial nerve canal, and forming a portion of the base and lateral wall of the cranium. Replacement of this bone is uncommon compared to other cranial bones and is generally reserved for extensive destruction from tumor, such as temporal bone malignancy, or severe trauma, where the mastoid, squamous, or petrous portions have been resected or fractured beyond simple repair. Because of the dense concentration of neurovascular structures nearby, including the facial nerve, cochlea, and internal carotid artery, replacement procedures demand careful attention to preserving or reconstructing pathways for hearing and facial function alongside restoring bony integrity. The right-sided designation is essential given the asymmetric, non-mirrored anatomy of hearing and balance structures that must be considered during planning.
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 should specify the material used, whether an autologous bone graft, titanium mesh, or synthetic implant, and confirm that it is taking the place of bone rather than merely reinforcing it. Coders need to identify the specific facial or cranial bone being replaced, since body part selection within this family is granular. A frequent error is coding Replacement when a graft is instead used to support a repair rather than substitute for missing bone, and another is confusing a temporary spacer or external fixation device, which does not qualify as replacement material, with a permanent implant.