0TS04ZZ
Reposition Kidney, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | S Reposition |
| Body Part | 0 Kidney, Right |
| Approach | 4 Percutaneous Endoscopic |
| 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 urinary structure to its normal location or to another suitable position when it has become displaced or malformed. A well-known example is correcting a horseshoe kidney or a kidney that has dropped from its normal position, and pyeloplasty performed to relocate and reshape the ureteropelvic junction so urine can drain properly.
These procedures address problems that are fundamentally about location or orientation rather than tissue damage - a kidney sitting too low, a ureter that takes an abnormal course, or a congenital anomaly discovered in childhood or found incidentally in an adult. Surgeons free the structure from surrounding attachments and fix it in its corrected position, sometimes with permanent sutures or mesh.
Because the underlying tissue is retained and simply relocated, Reposition differs from procedures that remove, replace, or reinforce urinary tissue.
Anatomy & Axis Detail
Kidney, Right
The right kidney is a retroperitoneal organ tucked below the liver, and repositioning it surgically means moving the organ to a new anatomic location without removing or altering its filtering tissue. This is done for conditions such as nephroptosis, where the kidney has descended and become mobile enough to cause pain or ureteral kinking, or to relocate a horseshoe or ectopic kidney, or to reposition a transplanted kidney intraoperatively before final fixation. The procedure typically involves nephropexy, anchoring the kidney's capsule or lower pole to the posterior abdominal wall or psoas fascia to restore normal position and prevent recurrent descent. Because the right kidney's proximity to the liver and duodenum narrows the surgical corridor compared with the left side, documentation should confirm laterality clearly, since right and left kidneys are distinct body part values in this axis.
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
The operative note needs to describe the structure being moved and confirm that the objective was relocation rather than removal or reconstruction with foreign material. This includes procedures for undescended or ectopic kidneys, correction of ureteral malposition, and pyeloplasty when it is performed primarily to reposition the renal pelvis and ureter rather than to excise a stricture.
A common error is coding pyeloplasty as Repair when the surgeon's actual technique involved detaching and relocating the ureteropelvic segment, which fits Reposition more precisely. Coders should also watch for procedures that combine repositioning with excision of a narrowed segment, since both root operations may need to be captured depending on what was documented.