0QS846Z
Reposition Femoral Shaft, Right to No Qualifier with Internal Fixation Device, Intramedullary, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | S Reposition |
| Body Part | 8 Femoral Shaft, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | 6 Internal Fixation Device, Intramedullary |
| Qualifier | Z 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 lower bone, or a fragment of one, from an abnormal location to its correct anatomical position, or to another location that will let it function properly. This is the category most fracture reductions fall into, along with corrective osteotomies performed to realign a bone that has healed crookedly or grown abnormally, and procedures that move a bone segment to a new site for reconstructive purposes.
These operations address displaced fractures of the pelvis, femur, tibia, fibula, patella, or foot bones, as well as deformities such as a bowed tibia or a malaligned metatarsal that needs to be cut and shifted into better alignment. Fixation devices like plates, screws, rods, or external fixators are frequently used alongside the repositioning to hold the bone in its new location while it heals.
Anatomy & Axis Detail
Femoral Shaft, Right
The right femoral shaft is the long, cylindrical diaphyseal segment of the thighbone between the proximal and distal metaphyses, and it withstands significant bending and torsional forces during ambulation. Reposition is performed for displaced or angulated shaft fractures, where the surgeon manipulates the bone fragments back into proper longitudinal and rotational alignment before any fixation device is applied. Because the femoral shaft is surrounded by large muscle groups and lies near the femoral vessels and sciatic nerve, careful traction and manual or instrument-assisted reduction are used to restore alignment safely. Coding reflects the shaft segment specifically, distinguishing it from reposition procedures involving the upper or lower femur.
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: Internal Fixation Device, Intramedullary
An intramedullary internal fixation device is a rod or nail inserted into the medullary canal of a long bone to stabilize a fracture from within, sharing load along the bone's central axis. It is distinguished from a rigid plate, which stabilizes the bone from its outer surface, and from the intramedullary limb lengthening variant, which adds a mechanism to gradually distract the bone.
Coding & Documentation
The operative note needs to document that a bone or bone fragment was moved to a different position, whether by closed manipulation or open surgical exposure, and should specify any fixation device left in place, since that device is captured as a separate value on the same code rather than a separate procedure. Coders must distinguish open versus percutaneous versus external approaches carefully, as this changes the approach value substantially. A common mistake is coding a simple cast application or splinting as Reposition when no manipulation of bone position actually occurred, and another is failing to capture the device value when hardware is placed during the same reduction.