0DSA7ZZ
Reposition Jejunum to No Qualifier with No Device, Via Natural or Artificial Opening Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | D Gastrointestinal System |
| Operation | S Reposition |
| Body Part | A Jejunum |
| Approach | 7 Via Natural or Artificial Opening |
| Device | Z No Device |
| 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 gastrointestinal structure to its normal anatomic location, or to another location that allows it to function properly, without cutting away or replacing any tissue. The classic example is surgical correction of malrotation in infants, where the small and large intestines are rearranged into a more typical configuration, but the category also covers reduction of a volvulus, correction of intestinal intussusception when done surgically rather than by enema, and repositioning a prolapsed rectum back into normal alignment.
These procedures address structures that are anatomically present and viable but sitting in the wrong place, whether from a congenital anomaly, a twist that developed over time, or a mechanical shift such as organ prolapse. Because the tissue itself is not removed or substituted, the surgery is fundamentally about untwisting, realigning, or fixing the organ in a corrected position, sometimes with sutures anchoring it there.
Anatomy & Axis Detail
Jejunum
The jejunum is the proximal, highly mobile portion of the small intestine beginning at the ligament of Treitz, and its mobility on a long mesenteric pedicle makes it a common site for internal herniation, volvulus, or displacement after prior abdominal surgery. Reposition restores a segment of jejunum that has moved into an abnormal location, such as reducing it from a hernia defect or untwisting a volved loop, back to its normal position without removing bowel tissue. Because jejunal viability depends on mesenteric blood flow that can be compromised by prolonged displacement or twisting, the segment should be assessed for adequate perfusion once repositioned. When a jejunal loop is also being used to reconstruct another structure, such as in a Roux-en-Y limb, that construction is coded separately from simple reposition.
Approach: Via Natural or Artificial Opening
Via Natural or Artificial Opening means the instrument reaches the target site by passing through an existing body orifice, such as the mouth or urethra, or a surgically created opening like a stoma, without additional incision or scope guidance. It is distinguished from the Endoscopic variant by the absence of a visualizing scope, and from External by actually traversing into the body through that opening.
Coding & Documentation
Assigning this code requires documentation that the organ was moved to a new or corrected position, distinct from documentation describing repair of a tear or removal of tissue. Operative notes for volvulus reduction or rectal prolapse correction should describe the maneuver used to untwist or realign the bowel and any fixation performed to hold it in place. A recurring coding error is applying Reposition when the procedure actually removed a segment of nonviable bowel after derotation, which instead requires Resection to be coded for that portion. Coders should also watch for cases where repositioning is performed alongside repair of an associated defect, both of which may need to be captured separately.