0QSNXZ2
Reposition Metatarsal, Right to Sesamoid Bone(s) 1st Toe with No Device, External Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | S Reposition |
| Body Part | N Metatarsal, Right |
| Approach | X External |
| Device | Z No Device |
| Qualifier | 2 Sesamoid Bone(s) 1st Toe |
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
Metatarsal, Right
The right metatarsals are the five long bones forming the forefoot skeleton, each articulating proximally with a tarsal bone and distally with a toe phalanx, and together they help form the transverse arch and bear weight during the push-off phase of gait. Reposition is performed when a metatarsal fracture or dislocation, frequently at the base of the fifth metatarsal or across the Lisfranc joint complex, has displaced the bone from its normal alignment. Restoring proper length and rotation matters because metatarsal malalignment can lead to abnormal weight distribution and painful callus formation under the sole. The approach, closed manipulation or open reduction, along with identification of which specific metatarsal was treated, should be reflected in the documentation.
Approach: External
External approach applies to procedures performed directly on the skin or mucous membrane, or on an accessible body surface, without any instrumentation passing through a puncture or orifice. It covers things like manual reduction of a fracture or excision of a skin lesion. It differs from Via Natural or Artificial Opening in that no internal passage is entered at all, only the exposed surface.
Qualifier: Sesamoid Bone(s) 1st Toe
Sesamoid Bone(s) 1st Toe specifies the small sesamoid bones embedded within the tendons at the base of the great toe as the qualifying structure in a foot bone procedure. These bones are commonly involved in bunion surgery and are distinguished from the metatarsal or phalangeal bones of the same toe that they sit beneath.
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.