0VR90JZ
Replacement Testis, Right to No Qualifier with Synthetic Substitute, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | V Male Reproductive System |
| Operation | R Replacement |
| Body Part | 9 Testis, Right |
| Approach | 0 Open |
| 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 involve removing a body part, or a portion of one, and putting in biological or synthetic material that takes over its physical role. In the male reproductive system this most often means placement of a penile prosthesis for erectile dysfunction that hasn't responded to other treatment, or insertion of a testicular prosthesis after orchiectomy to restore scrotal appearance. These devices don't restore natural biological function but are built to occupy the space and, in the case of penile implants, allow mechanical rigidity for intercourse.
Patients typically pursue these procedures after other options - medication, injections, vacuum devices - have failed, or as a reconstructive step following removal of an organ for cancer, trauma, or infection. The replaced material stays in the body permanently unless later removed or revised.
Anatomy & Axis Detail
Testis, Right
Replacement of the right testis involves placing a testicular prosthesis into the scrotal sac to restore the physical presence and contour of the organ, most commonly after orchiectomy for testicular cancer, following loss from trauma or torsion, or as part of staged reconstruction after a congenital absence. The procedure is primarily cosmetic and psychological in intent, since the silicone or saline implant does not restore endocrine or reproductive function, and it is typically performed through the same scrotal or inguinal incision used for the prior removal once healing has occurred. Sizing and positioning within the scrotum matter for symmetry with the contralateral testis, and the operative note should confirm that a prosthetic device, rather than native or donor tissue, was implanted to support the replacement code.
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: 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 Replacement requires documentation confirming that a prosthetic device was actually inserted to take the place of the body part, not merely that a defect was patched. A frequent mistake is coding Replacement when a testicular prosthesis is placed during the same operative session as an orchiectomy performed for a separate reason - these are typically two distinct procedures and both should be captured. Coders also need to note whether the device is inflatable or non-inflatable and whether one or two corporeal cylinders were placed, since this affects the device value used.