0QT80ZZ
Resection Femoral Shaft, Right 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 | 8 Femoral Shaft, 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
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.
