0DTM7ZZ
Resection Descending Colon to No Qualifier with No Device, Via Natural or Artificial Opening Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | D Gastrointestinal System |
| Operation | T Resection |
| Body Part | M Descending Colon |
| Approach | 7 Via Natural or Artificial Opening |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection describes the surgical removal of an entire gastrointestinal organ or a clearly defined anatomic segment of one, without putting anything in its place. Common examples include total gastrectomy for stomach cancer, complete removal of the appendix, and total colectomy for severe ulcerative colitis, where the entire designated body part as defined by the coding system is taken out rather than just a portion of it.
Surgeons choose resection when disease, most often cancer, severe inflammatory conditions, or irreversible ischemic damage, affects an entire organ or a segment that the classification treats as a whole unit, such as the cecum or the sigmoid colon. The remaining ends of the digestive tract are typically reconnected in the same operation, restoring continuity, though in some cases a stoma is created instead when reconnection is not immediately safe.
Anatomy & Axis Detail
Descending Colon
The descending colon runs from the splenic flexure to the sigmoid colon along the left retroperitoneum and is supplied by branches of the inferior mesenteric artery, making it a common site for diverticular disease due to relatively lower luminal caliber and higher intraluminal pressure. Resection here is performed for descending colon carcinoma, complicated diverticulitis with abscess, fistula, or stricture, or ischemic colitis in the region, and because the descending colon lies in a watershed zone between the superior and inferior mesenteric circulations, it is particularly susceptible to ischemic compromise after ligation of feeding vessels. Mobilization requires incising the lateral peritoneal attachments along the white line of Toldt. Documentation should confirm the resected segment is limited to the descending colon rather than extending proximally to the splenic flexure or distally into the sigmoid.
Approach: Via Natural or Artificial Opening
Via Natural or Artificial Opening means the instrument reaches the target site by passing through an existing body orifice, such as the mouth or urethra, or a surgically created opening like a stoma, without additional incision or scope guidance. It is distinguished from the Endoscopic variant by the absence of a visualizing scope, and from External by actually traversing into the body through that opening.
Coding & Documentation
The key documentation requirement is that the entire body part, as defined by the specific GI body part value, was removed, not merely a partial excision of tissue from within it. When only part of a segment is taken, such as a wedge of stomach tissue, the correct root operation is Excision rather than Resection, which is one of the most common assignment errors in this family. Coders must also identify whether an anastomosis, stoma, or other reconstruction was performed and code that separately from the resection itself, since the two are distinct steps. Clear identification of the specific segment removed, such as right colon versus left colon versus total colon, is essential because each maps to a different body part value.