0ST90ZZ
Resection Hip Joint, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | S Lower Joints |
| Operation | T Resection |
| Body Part | 9 Hip Joint, 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
Resection in the lower joints means surgically removing an entire joint or joint structure without replacing it with any device. This is less common than joint replacement, typically reserved for severe infection that has destroyed a joint, a tumor requiring removal of the joint surfaces, or a salvage option after a failed implant cannot be replaced right away. A well-known example is resection arthroplasty of the hip, sometimes called a Girdlestone procedure, where the femoral head is removed and the space fills with scar tissue.
Because no artificial joint is inserted, patients typically have a shortened limb and altered mechanics, and mobility aids or later reconstruction may follow. This trade-off is usually accepted specifically to clear infection or malignant tissue threatening the limb.
Anatomy & Axis Detail
Hip Joint, Right
The right hip is a deep ball-and-socket joint formed by the femoral head and the acetabulum, surrounded by a strong capsule and reinforced by the labrum. Resection of the hip joint removes the femoral head, acetabular articular surface, or both, and is performed for end-stage osteoarthritis, avascular necrosis, chronic joint infection requiring source control, or tumor involvement of the proximal femur or acetabulum. A common clinical scenario is a Girdlestone resection arthroplasty, in which the femoral head and neck are excised and the joint left unreconstructed, typically as a staged step before later reimplantation or as definitive treatment in patients unfit for prosthesis. Because total hip arthroplasty replaces rather than merely removes the joint, that procedure is coded as replacement, so documentation should specify whether an implant was placed in the same setting.
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
A coder should look for documentation that the joint or a defined structure was entirely removed and nothing was implanted in its place; if a spacer or prosthesis went in during the same operation, the case likely calls for Replacement or a combination of codes instead of Resection alone. Infection control, pathology reports for malignancy, and prior failed hardware are common clinical justifications. The most frequent error is coding Resection when an antibiotic cement spacer was actually placed, since a spacer typically reclassifies the procedure as Replacement.