0QTS0ZZ
Resection Coccyx to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | T Resection |
| Body Part | S Coccyx |
| 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
This family covers the surgical removal of an entire bone or bony structure in the leg, foot, pelvis, or related lower-body skeletal segment, without putting anything back in its place. It applies to structures such as the femur, tibia, fibula, patella, pelvic bones, tarsals, metatarsals, and toe phalanges. Surgeons turn to it when a bone segment is destroyed by infection, riddled with tumor, so badly fractured that repair isn't feasible, or deformed beyond what osteotomy or reshaping could correct.
Because resection takes out the whole named bony part rather than a fragment, it is a bigger step than excision or debridement. Patients encounter it most often in the context of bone cancer (primary or metastatic), chronic osteomyelitis that has not responded to antibiotics, or severe joint destruction where the diseased bone end must be cleared away before a prosthesis or graft can be placed. Depending on the site, the surgeon may reconstruct with a graft, implant, or amputation-level closure in a separate, later procedure.
Anatomy & Axis Detail
Coccyx
The coccyx is the small triangular bone at the caudal end of the vertebral column, formed by three to five fused or partially fused vertebral segments and serving as an attachment point for pelvic floor muscles and ligaments rather than bearing significant structural load. Complete resection, or coccygectomy, is performed for chronic coccydynia refractory to conservative treatment, sacrococcygeal tumors such as chordoma, or pilonidal disease with chronic sinus tracts extending to the bone, and because the coccyx sits adjacent to the rectum and anal sphincter complex, the procedure carries meaningful risk of wound complications and requires careful dissection. As there is no laterality or further subdivision, the coccyx is coded as a single distinct body part.
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 operative note has to state that an entire named bony part was removed, not a portion of it - documentation reading "partial resection" or "removed a segment of the shaft" points instead to Excision. Coders should confirm the specific bone or bone group from the ICD-10-PCS body part table (e.g., distal femur vs. entire femur can carry different values) and check whether the pathology report or op note supports a diagnosis - like tumor or osteomyelitis - that clinically justifies total removal.
A frequent error is defaulting to Resection whenever a large piece of bone is taken, when the correct read is Excision if any portion of the bone remains. Another is missing a same-operative-session Replacement or Supplement, which should be coded separately if a graft or device is placed after the bone is removed.