0LTS4ZZ
Resection Ankle Tendon, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | T Resection |
| Body Part | S Ankle Tendon, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection removes an entire tendon, or a clearly defined tendon body part, without putting in any replacement material. This is a less common tendon procedure than repair or reposition, and it is typically performed when a tendon is so severely diseased, degenerated, or tumor-involved that removing it entirely is the safest or most effective option, rather than attempting to preserve and repair it.
Examples include excising a tendon segment infiltrated by a soft tissue tumor, removing a chronically diseased tendon that is causing ongoing pain and dysfunction with no reasonable prospect of repair, or excising an entire tendon as part of managing a severe infection that has destroyed the tissue. Because tendons connect muscle to bone, complete resection without any subsequent reconstruction can leave a functional deficit, so it is often paired with a separate reconstructive procedure, sometimes performed later, to restore movement.
Anatomy & Axis Detail
Ankle Tendon, Right
The right ankle's tendons, including the Achilles tendon posteriorly and the tibialis, peroneal, and extensor tendons that cross anteriorly and laterally, guide the foot through a narrow range of motion within tightly confined synovial sheaths, and complete resection of one is typically performed for tumor, chronic infected tenosynovitis, or a tendon so degenerated or ruptured that primary repair is not viable. Because these tendons run in close proximity to the malleoli, retinacula, and neurovascular bundles at the ankle, full excision requires precise dissection to avoid destabilizing the joint or injuring adjacent nerves and vessels. Removing an ankle tendon in its entirety, particularly the Achilles, has a major impact on push-off strength and gait, so reconstruction with tendon transfer or grafting is standard practice following resection. The ankle's many named tendons make specific documentation of which one was resected essential for accurate coding.
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 root operation applies only when an entire named tendon body part, not merely a segment or the whole tendon down to its full anatomic extent, is being cut out and nothing biological or synthetic is placed to take its structural role. Coders should confirm the operative note describes complete excision of the tendon at that body part value, and check whether any reconstructive graft was placed at the same time, since combined excision and grafting is coded as Replacement instead.
A common assignment mistake is applying Resection when only part of a tendon was removed and the remaining tendon was repaired or trimmed, which should instead be coded as Excision or Repair depending on the amount and intent of tissue removed. Coders should also watch for tumor cases where a wider excision spans tendon and adjacent soft tissue, which may require coding to more than one body system.
