07SM0ZZ
Reposition Thymus to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | S Reposition |
| Body Part | M Thymus |
| Approach | 0 Open |
| 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 lymphatic or hemic body part - almost always the spleen in this system - back to its normal location, or to another location that will let it function properly, when it has shifted out of place. The best-known example is splenopexy, performed for a wandering spleen, a condition in which the ligaments that normally anchor the spleen are loose or absent, allowing it to move freely within the abdomen and sometimes twist on its blood supply. Fixing the spleen in its proper anatomic position prevents that twisting, which can otherwise cut off circulation and destroy the organ.
This procedure preserves the spleen rather than removing it, which is generally preferred when the organ is still viable, since the spleen plays an ongoing role in filtering blood and supporting immune function.
Anatomy & Axis Detail
Thymus
The thymus lies in the anterior mediastinum, straddling the great vessels above the heart, and its position is repositioned surgically far less often than it is resected, typically in the context of correcting an ectopic or displaced gland found during evaluation of a mediastinal mass or in association with myasthenia gravis workup. Because the gland sits close to the innominate vein, phrenic nerves, and pericardium, moving it to a new location without detaching its blood supply requires careful dissection to preserve the venous drainage that runs directly into the left brachiocephalic vein. Documentation should specify the mediastinal approach, whether sternotomy or thoracoscopic, and confirm that the gland was mobilized and secured in its corrected anatomic position rather than removed, distinguishing the procedure from thymectomy performed for thymoma or thymic hyperplasia.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Coding & Documentation
The operative note needs to describe a body part being moved to a different location, with no tissue removed or added - just relocation, typically followed by suturing or fixation to hold it in place. Coders should distinguish repositioning from a repair that happens to involve some tissue manipulation without an actual change of anatomic location. A common error is applying Reposition to any procedure involving the word "pexy" without confirming that true relocation, rather than simple reinforcement or attachment, took place. Because Reposition is uncommon in this body system outside of splenopexy, coders unfamiliar with the procedure sometimes default to Repair instead, which would be incorrect if the documentation clearly shows the organ being moved and fixed in a new position.