0GTD4ZZ
Resection Aortic Body to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | G Endocrine System |
| Operation | T Resection |
| Body Part | D Aortic Body |
| 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 in the endocrine system means the complete surgical removal of a gland such as the thyroid, a parathyroid gland, an adrenal gland, or the pituitary, without any replacement structure put in its place. It is one of the most frequently performed procedures in endocrine surgery because so many endocrine conditions, from cancer to hormone-secreting tumors to autoimmune overactivity, are best treated by taking the entire gland out.
Common reasons include thyroid cancer or a large multinodular goiter, Graves' disease that has not responded to medication, a parathyroid adenoma causing hyperparathyroidism, an adrenal tumor such as a pheochromocytoma, or a pituitary tumor removed through the skull base. Because these glands regulate metabolism, blood pressure, calcium balance, and stress hormones, patients undergoing resection typically need lifelong hormone replacement or monitoring afterward, which their care team discusses well before surgery.
Anatomy & Axis Detail
Aortic Body
The aortic body is a chemoreceptor cluster located near the arch of the aorta, close to the origins of the great vessels, that senses blood oxygen and carbon dioxide to contribute to respiratory and cardiovascular reflex control. Resection is uncommon and generally performed when this tissue develops a paraganglioma, a vascular tumor that can present as a mediastinal mass and, depending on size and location, cause local compressive symptoms or be found incidentally on cross-sectional imaging. Given its position adjacent to the aortic arch and major thoracic vessels, excision typically requires a thoracic surgical approach with careful vascular control and attention to nearby vagal and recurrent laryngeal nerve branches. Complete removal of the chemoreceptor mass, rather than biopsy or partial debulking, is what is coded as Resection at this site.
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
The operative report must confirm the entire gland was removed, not a lobe, nodule, or partial gland, since a partial removal is coded as excision instead. When a total thyroidectomy is performed in stages or as completion surgery after a prior partial removal, coders need to check whether any residual tissue remained from the earlier operation and code accordingly. A common mistake is coding bilateral adrenalectomy or parathyroidectomy as a single procedure when each gland is a separate body part value requiring its own code. Coders should also watch for cases where a resection is combined with a separate reconstructive or reconstructive-adjacent step, such as autotransplantation of a parathyroid gland fragment, which requires an additional code.