ICD-10-PCS Billable Code

0BTF0ZZ

Resection Lower Lung Lobe, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemB Respiratory System
OperationT Resection
Body PartF Lower Lung Lobe, Right
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

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

Procedure Overview

Resection describes the complete surgical removal of an entire respiratory structure without replacing it, and in this body system it most often refers to pneumonectomy, the removal of an entire lung, most commonly performed for lung cancer that cannot be controlled with a smaller resection. It also covers total removal of a lobe when the whole lobe is taken, though partial lobe removal is classified differently.

These are major operations reserved for situations where disease, most often malignancy but sometimes severe infection or destroyed lung tissue, involves an entire anatomically distinct structure, making anything less than complete removal insufficient. Patients undergoing these procedures typically face a lasting reduction in lung capacity, so candidacy is carefully weighed against overall lung function beforehand.

Anatomy & Axis Detail

Lower Lung Lobe, Right

The right lower lobe is the largest lobe of the right lung, situated below the oblique fissure and supplied by multiple segmental bronchi and a substantial branch of the pulmonary artery. Lobectomy of this lobe is commonly performed for malignancy, extensive bronchiectasis, or lung abscess confined to the lower lobe, and its size means the procedure typically involves ligating several segmental arterial branches along with the lower lobe bronchus and vein. Its proximity to the diaphragm and the inferior pulmonary ligament requires that ligament to be divided to fully mobilize the lobe before removal. As with other lobar resections, the documentation should reflect complete excision of the lobe's parenchyma and its dedicated vasculature and airway, confirming this as a resection rather than a partial excision.

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 report must clearly state that an entire named anatomical unit, a whole lung, a whole lobe, or the whole trachea, was removed, since ICD-10-PCS Resection requires completeness of that structure. A frequent coding error is applying Resection to a lobectomy when only part of a lobe was actually removed, or applying it to a wedge resection of lung tissue, both of which should be coded as Excision because they remove only a portion of the body part.

Commonly Confused With

ExcisionThe essential distinction is with Excision, used whenever only a part of a respiratory structure is cut out rather than the whole named unit, such as a wedge resection or segmentectomy.
TransplantationIt's also distinct from Transplantation, since Resection removes tissue permanently without a replacement organ being implanted in the same family of codes.