0MSK4ZZ
Reposition Perineum Bursa and Ligament to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | S Reposition |
| Body Part | K Perineum Bursa and Ligament |
| 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 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
Perineum Bursa and Ligament
The perineum bursa and ligament group covers connective tissue support structures of the perineal region, including portions of the perineal body and associated ligamentous attachments that help maintain pelvic floor integrity. Reposition in this area is typically performed to correct displacement resulting from obstetric trauma, pelvic organ prolapse repair, or prior perineal surgery, with the goal of restoring the ligament to its normal anatomic position and function. Given the proximity of the perineum to the anal sphincter, urethra, and vaginal or scrotal structures, the surgeon must proceed with careful attention to these adjacent organs. Documentation should make clear that the procedure addresses ligamentous or bursal tissue specifically, distinguishing it from repair of muscle or sphincter structures coded under other body systems.
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.