ICD-10-PCS Billable Code

0MTL4ZZ

Resection Hip Bursa and Ligament, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemM Bursae and Ligaments
OperationT Resection
Body PartL Hip Bursa and Ligament, Right
Approach4 Percutaneous Endoscopic
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Cutting out or off, without replacement, all of a body part

Procedure Overview

Resection procedures in this family involve cutting out an entire bursa or ligament without replacing it, typically because the structure has become a source of chronic pain, inflammation, or dysfunction that outweighs its remaining usefulness. A classic example is bursectomy for chronic olecranon or prepatellar bursitis that has failed conservative treatment, where the inflamed bursal sac is excised in its entirety rather than drained or repaired.

Surgeons pursue full resection when a bursa is persistently infected, calcified, or thickened, or when a ligament is so degenerated or contributing to impingement that removing it altogether is more beneficial than attempting repair. Unlike partial excisions performed to biopsy or debride tissue, resection removes the whole named structure. Patients typically recover well because bursae and many accessory ligaments are not essential to joint function once inflammation is resolved.

Anatomy & Axis Detail

Hip Bursa and Ligament, Right

The right hip bursae and ligaments, most notably the iliofemoral, pubofemoral, and ischiofemoral ligaments along with the trochanteric and iliopsoas bursae, reinforce the hip capsule and reduce friction between tendons and bone during gait. Resection is typically performed for a chronically inflamed or calcified trochanteric bursa, a torn or degenerated capsular ligament, or fibrous tissue impinging on the joint, all localized to the right hip. Because these structures lie adjacent to the sciatic nerve, femoral neurovascular bundle, and the hip capsule itself, the surgeon must remove the targeted ligament or bursa in its entirety while protecting the joint's remaining stabilizers. Accurate laterality is required in documentation, and the note should distinguish whole-structure excision from a partial debridement, which would instead be coded as excision.

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

A coder selects Resection when the documentation confirms complete removal of an entire bursa or ligament, not just a portion, and no replacement or graft material is used. Look for terms such as "bursectomy," "complete excision," or "ligament removed in its entirety." A common error is applying Resection when only part of the structure was taken, which should instead be coded as Excision, a distinct root operation reserved for partial removal. Coders also need to verify that removal was not a preliminary step to a Replacement procedure performed in the same operative episode, which would require separate coding.

Commonly Confused With

ExcisionExcision is the most commonly confused pairing, since both involve cutting tissue out - the deciding factor is completeness: Resection takes the whole bursa or ligament, while Excision removes only a portion.
ReplacementReplacement can appear similar when a ligament is removed, but Replacement always involves implanting graft or synthetic material afterward, whereas Resection leaves nothing behind.
RepairRepair is unrelated in intent, since it aims to preserve and restore the structure rather than eliminate it.