0PTM0ZZ
Resection Carpal, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | P Upper Bones |
| Operation | T Resection |
| Body Part | M Carpal, Right |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection covers the surgical removal of an entire bone or a complete anatomically distinct portion of a bone within the skull, facial skeleton, thorax, or upper limb, without any device or material put in its place as part of the same code. Examples include removal of an entire clavicle for a tumor, excision of a whole rib, or removal of a full carpal bone.
This is typically performed for aggressive bone tumors, severe infection such as osteomyelitis that has destroyed the bone, or as part of a larger reconstructive plan where the diseased segment must come out before any rebuilding can occur. Because no replacement device is coded here, resection is often just the first step of a staged repair.
Anatomy & Axis Detail
Carpal, Right
The carpal bones are the eight small bones of the wrist arranged in two rows that permit the complex gliding and rotational motion between the forearm and hand while transmitting load from the palm to the radius. Resection of a carpal bone is performed for isolated tumors such as giant cell tumor of bone, avascular necrosis with collapse as seen in Kienbock disease affecting the lunate, or chronic infection localized to a single carpal element. Because the carpals are tightly interlocked by an intrinsic ligamentous network, removing one bone alters the kinematics of the entire wrist, so the operative note usually specifies which carpal was excised and whether a silicone spacer, tendon interposition, or partial fusion was performed to fill the resulting gap. Coders should confirm the specific carpal involved, since ICD-10-PCS does not further subdivide this body part by individual bone name.
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 key documentation requirement is that the entire named body part, or a coded subdivision of it, is removed - partial removal of a bone that leaves a portion behind should be coded as excision instead, which falls outside this family. Coders need to check the specific body part values available for upper bones, since some are defined at the level of an individual bone (clavicle, scapula) while others are grouped, which changes whether a partial removal still qualifies as resection. A frequent error is coding resection when only a segment of a long bone like the humerus was removed rather than the whole bone, which should be excision. Another is failing to code a separate replacement or supplement procedure when reconstruction was performed in the same operative session.