0TT14ZG
Resection Kidney, Left to Hand-Assisted with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | T Resection |
| Body Part | 1 Kidney, Left |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | G Hand-Assisted |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection removes an entire urinary organ or a complete anatomical segment of one, without replacing it with substitute tissue or material. Total nephrectomy for kidney cancer, complete cystectomy for invasive bladder cancer, and total removal of a diseased ureter are typical examples within this family.
These procedures are performed when disease - most often cancer, but sometimes severe infection or a nonfunctioning organ - affects an entire structure and cannot be adequately treated by removing only the affected portion. Because Resection takes the whole organ or whole anatomical segment, it is generally reserved for advanced or extensive disease rather than localized findings.
Patients undergoing these procedures often need additional reconstructive or diversion procedures afterward, such as creation of a urinary conduit following cystectomy, which are coded as their own separate procedures.
Anatomy & Axis Detail
Kidney, Left
The left kidney sits retroperitoneally beneath the diaphragm and spleen, its position and proximity to the splenic vasculature and tail of the pancreas shaping the surgical approach when the entire organ is removed. Resection here typically addresses renal cell carcinoma, a nonfunctioning kidney from chronic obstruction or infection, or severe trauma, and is performed via open flank incision, laparoscopy, or robotic-assisted technique. Because the left renal vein is longer and receives the gonadal and adrenal veins, ligation sequencing differs slightly from the right side. The ipsilateral ureter and adrenal gland may or may not be taken depending on pathology, but code assignment for simple nephrectomy reflects removal of the kidney parenchyma alone; documentation should specify laterality and confirm no partial sparing occurred, distinguishing this from a partial resection.
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.
Qualifier: Hand-Assisted
This qualifier indicates that a laparoscopic or endoscopic procedure was performed with the surgeon's hand inserted through a separate incision to provide tactile feedback and manual assistance alongside the instruments. It distinguishes hand-assisted minimally invasive technique from standard laparoscopic approaches performed with instruments alone.
Coding & Documentation
Coders need documentation confirming that an entire organ or an entire anatomically distinct segment - a whole kidney, a whole ureter, or the entire bladder - was removed, not just a portion of it. The pathology and operative reports together should establish the extent of what was taken, since removal of only part of a segment falls under Excision instead.
The most common assignment error is applying Resection to a partial nephrectomy or partial cystectomy, which are Excision because tissue remains behind. Coders should also separately capture any reconstruction, diversion, or replacement procedure performed in the same session, since those are not bundled into the Resection code itself.