ICD-10-PCS Billable Code

0MSH4ZZ

Reposition Abdomen Bursa and Ligament, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemM Bursae and Ligaments
OperationS Reposition
Body PartH Abdomen Bursa and Ligament, Right
Approach4 Percutaneous Endoscopic
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Moving to its normal location, or other suitable location, all or a portion of a body part

Procedure Overview

Reposition procedures move a bursa or, more often, a ligament from an abnormal location back to its correct anatomic position, or to another location that will let it function properly. A common scenario is surgical repositioning of a chronically dislocating patellar or biceps tendon-associated ligamentous structure, or realignment of a displaced ligament following trauma, where the tissue itself is healthy but sitting in the wrong place.

This differs from most other procedures in the family because the ligament or bursa is not cut out, replaced, or reinforced - it is detached, moved, and reattached or otherwise secured in its new position. Surgeons choose this approach when a structural malalignment, rather than tissue damage, is causing pain, instability, or abnormal joint mechanics, such as recurrent shoulder or kneecap dislocation. Restoring normal alignment allows the joint to track and load correctly, reducing repeat injury and improving comfort with movement.

Anatomy & Axis Detail

Abdomen Bursa and Ligament, Right

The right abdomen bursa and ligament group encompasses connective structures such as the falciform, round, and other peritoneal-associated ligaments on the right side of the abdominal wall that support visceral position and wall integrity. Reposition is performed when one of these ligaments has become displaced, for instance following trauma, hernia repair, or a prior surgical procedure that disrupted its normal attachment, and the surgeon returns it to its correct anatomic location. Because the right abdomen contains the liver and portions of the biliary tree, the surgeon must work carefully to avoid disturbing adjacent organs during mobilization of the ligament. Documentation should clearly identify laterality and the specific ligament involved, since abdominal wall ligaments on the left side are 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.

Coding & Documentation

This code applies when the operative note describes moving a bursa or ligament to a new site and securing it there, using language such as "transposed," "relocated," or "repositioned." The coder should confirm the structure itself was not resected or supplemented with additional material during the move - only its location changed. A frequent mistake is coding Reposition when a ligament was actually released and reattached at its original insertion point after debridement, which may better reflect Repair. Coders should also verify the correct body part is selected based on the ligament's final anatomic location rather than its origin.

Commonly Confused With

RepairRepair is the operation most likely to be confused here, since both can involve reattaching tissue; the distinction is whether the structure is being fixed in its original position (Repair) or deliberately moved to a different one (Reposition).
ReplacementReplacement should not be selected unless the native ligament is removed and substituted with graft material, which is not the case in a pure repositioning procedure.
ReleaseRelease, found under a different root operation, applies when the goal is simply to free a ligament or bursa from surrounding scar tissue without relocating it.