07T84ZZ
Resection Lymphatic, Internal Mammary, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 7 Lymphatic and Hemic Systems |
| Operation | T Resection |
| Body Part | 8 Lymphatic, Internal Mammary, 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 covers the complete removal of an entire lymphatic or hemic body part, without replacing it, and is one of the more consequential procedure types in this family because it permanently eliminates that structure. The most familiar example is total splenectomy, removing the entire spleen after severe trauma, certain blood disorders, or an enlarged spleen that is failing or at risk of rupture. Other examples include complete thymectomy for thymic tumors or myasthenia gravis, and full lymphadenectomy, where an entire chain or region of lymph nodes is removed, often as part of cancer staging or treatment to prevent disease spread.
Because these organs and nodes support immune defense and fluid balance, patients undergoing resection are usually counseled about the tradeoffs, such as increased infection risk after splenectomy, before the procedure is performed.
Anatomy & Axis Detail
Lymphatic, Internal Mammary, Right
The right internal mammary lymph nodes lie along the internal mammary vessels just lateral to the sternum, deep to the costal cartilages, and drain the medial breast, making them a recognized site of metastasis in breast cancer, particularly for tumors in the medial or central quadrants. Resection of this chain is far less common than axillary dissection and is generally reserved for cases where imaging or sentinel node mapping identifies disease specifically in this basin, since accessing the nodes requires working near the internal mammary artery and vein within the chest wall or through an extension of a mastectomy incision. Because these nodes are anatomically and prognostically distinct from axillary nodes, their involvement is documented separately, and resection here is coded apart from any concurrent axillary or thoracic lymphatic procedure.
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
Documentation must clearly state that the entire body part was removed, not a portion of it, since removing only part of an organ or only some nodes in a chain is coded as Excision rather than Resection. This distinction is one of the most frequent sources of coding errors in this family, especially with lymphadenectomies, where a note describing removal of "regional lymph nodes" needs to specify whether the entire nodal chain or basin was taken versus a sampling of nodes. Coders also need to confirm the specific body part value that matches the region resected, such as spleen versus a named lymph node group, and should check whether any adjacent structures were resected in the same operation, which would require additional codes.