07T64ZZ
Resection Lymphatic, Left Axillary 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 | 6 Lymphatic, Left Axillary |
| 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, Left Axillary
Left axillary lymph nodes drain the left breast, chest wall, and upper extremity and are resected under the same clinical circumstances as their right-sided counterpart, most commonly for staging or treatment of left breast cancer following a positive sentinel node biopsy, or for melanoma of the left arm or trunk. The dissection plane again must respect the axillary vein and the long thoracic, thoracodorsal, and intercostobrachial nerves, structures whose preservation determines whether the patient develops lasting lymphedema or numbness. Because axillary dissection can range from limited sentinel node excision to a full multilevel clearance, the operative report should specify the extent of the procedure. Laterality is essential to correct coding, and left axillary resection is captured as a distinct body part from the right despite identical anatomic and technical considerations.
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.
