0BTK4ZZ
Resection Lung, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | B Respiratory System |
| Operation | T Resection |
| Body Part | K Lung, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z 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
Lung, Right
The right lung has three lobes and the widest, most vertical main bronchus, features that shape how pneumonectomy is approached and documented. Complete resection is undertaken for centrally located non-small cell carcinoma, extensive bronchiectasis, or destroyed lung from tuberculosis or fungal disease when the tumor or damage crosses lobar boundaries and lesser resections cannot achieve clear margins or functional benefit. Because the right lung normally supplies more pulmonary function than the left, surgeons weigh cardiopulmonary reserve carefully before committing to total removal, often after pulmonary function and perfusion scanning. The procedure requires division and closure of the right main bronchus, pulmonary artery branches, and superior and inferior pulmonary veins, with the bronchial stump reinforced to reduce fistula risk given its exposure to the mediastinum and pericardial contact.
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
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.