ICD-10-PCS Billable Code

0MTQ4ZZ

Resection Ankle Bursa and Ligament, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemM Bursae and Ligaments
OperationT Resection
Body PartQ Ankle Bursa and Ligament, Right
Approach4 Percutaneous Endoscopic
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Cutting out or off, without replacement, all of a body part

Procedure Overview

Resection procedures in this family involve cutting out an entire bursa or ligament without replacing it, typically because the structure has become a source of chronic pain, inflammation, or dysfunction that outweighs its remaining usefulness. A classic example is bursectomy for chronic olecranon or prepatellar bursitis that has failed conservative treatment, where the inflamed bursal sac is excised in its entirety rather than drained or repaired.

Surgeons pursue full resection when a bursa is persistently infected, calcified, or thickened, or when a ligament is so degenerated or contributing to impingement that removing it altogether is more beneficial than attempting repair. Unlike partial excisions performed to biopsy or debride tissue, resection removes the whole named structure. Patients typically recover well because bursae and many accessory ligaments are not essential to joint function once inflammation is resolved.

Anatomy & Axis Detail

Ankle Bursa and Ligament, Right

The right ankle's ligaments, including the anterior talofibular, calcaneofibular, and deltoid ligaments, along with periarticular bursae, provide critical stability against inversion and eversion stress at a joint that bears substantial repetitive load. Resection is performed when a ligament is irreparably scarred from chronic instability or when a bursa has become a persistent, symptomatic mass, and the decision is made to remove the entire structure rather than repair or reinforce it. The ankle's confined space and the proximity of the peroneal tendons and superficial nerves require meticulous technique to excise the targeted tissue without destabilizing adjacent structures needed for continued joint function. Right-sided laterality must be specified, and documentation should confirm that the whole ligament or bursa was taken rather than a partial segment.

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

A coder selects Resection when the documentation confirms complete removal of an entire bursa or ligament, not just a portion, and no replacement or graft material is used. Look for terms such as "bursectomy," "complete excision," or "ligament removed in its entirety." A common error is applying Resection when only part of the structure was taken, which should instead be coded as Excision, a distinct root operation reserved for partial removal. Coders also need to verify that removal was not a preliminary step to a Replacement procedure performed in the same operative episode, which would require separate coding.

Commonly Confused With

ExcisionExcision is the most commonly confused pairing, since both involve cutting tissue out - the deciding factor is completeness: Resection takes the whole bursa or ligament, while Excision removes only a portion.
ReplacementReplacement can appear similar when a ligament is removed, but Replacement always involves implanting graft or synthetic material afterward, whereas Resection leaves nothing behind.
RepairRepair is unrelated in intent, since it aims to preserve and restore the structure rather than eliminate it.