07TL4ZZ
Resection Cisterna Chyli to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | T Resection |
| Body Part | L Cisterna Chyli |
| 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 covers the complete removal of an entire lymphatic or hemic body part, without replacing it, and is one of the more consequential procedure types in this family because it permanently eliminates that structure. The most familiar example is total splenectomy, removing the entire spleen after severe trauma, certain blood disorders, or an enlarged spleen that is failing or at risk of rupture. Other examples include complete thymectomy for thymic tumors or myasthenia gravis, and full lymphadenectomy, where an entire chain or region of lymph nodes is removed, often as part of cancer staging or treatment to prevent disease spread.
Because these organs and nodes support immune defense and fluid balance, patients undergoing resection are usually counseled about the tradeoffs, such as increased infection risk after splenectomy, before the procedure is performed.
Anatomy & Axis Detail
Cisterna Chyli
The cisterna chyli is a small dilated sac located near the upper lumbar spine where lymphatic trunks from the abdomen, pelvis, and lower limbs converge before draining into the thoracic duct. It is rarely operated on in isolation, and resection of this structure is typically undertaken only when a tumor, cyst, or traumatic injury directly involves this collecting reservoir, often discovered incidentally during retroperitoneal or aortic surgery. Its deep location adjacent to the aorta and vertebral bodies makes surgical access technically demanding and increases the risk of collateral vascular injury during dissection. Because the cisterna chyli serves as the confluence point for lymph draining the entire lower body, its removal can provoke significant chylous ascites or leakage, so documentation should confirm that this specific reservoir, rather than an adjacent lymph node group, was the structure excised.
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
Documentation must clearly state that the entire body part was removed, not a portion of it, since removing only part of an organ or only some nodes in a chain is coded as Excision rather than Resection. This distinction is one of the most frequent sources of coding errors in this family, especially with lymphadenectomies, where a note describing removal of "regional lymph nodes" needs to specify whether the entire nodal chain or basin was taken versus a sampling of nodes. Coders also need to confirm the specific body part value that matches the region resected, such as spleen versus a named lymph node group, and should check whether any adjacent structures were resected in the same operation, which would require additional codes.