ICD-10-PCS Billable Code

0QT80ZZ

Resection Femoral Shaft, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
OperationT Resection
Body Part8 Femoral Shaft, Right
Approach0 Open
DeviceZ No Device
QualifierZ 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

Femoral Shaft, Right

The right femoral shaft is the long diaphyseal segment between the proximal and distal metaphyses, providing the femur's principal structural column during standing and ambulation. Resection removes this entire midshaft segment, a procedure performed for diaphyseal osteosarcoma or Ewing sarcoma, extensive segmental osteomyelitis, or nonunion with bone loss that cannot be salvaged by lesser means. Because the shaft carries the bulk of axial load transmitted through the leg, its removal creates a large intercalary defect that must be bridged, commonly with a segmental allograft, vascularized fibular graft, or a modular intercalary endoprosthesis, to restore limb length and continuity. This distinguishes shaft resection from procedures on the femoral head, neck, or condyles, which involve different reconstructive strategies and functional consequences.

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.

Commonly Confused With

ExcisionExcision is the closest neighbor and the most common miscode: it applies when only part of a bone is cut out, leaving the rest intact, while Resection requires the entire body part to be gone.
DetachmentDetachment is used instead when the resected structure is a limb or a portion cut off at a joint as an amputation-type procedure, which follows different body part values.
ReplacementReplacement should not be confused with Resection itself, though the two frequently occur together when a resected bone segment is immediately replaced with an implant or graft.