ICD-10-PCS Billable Code

07T34ZZ

Resection Lymphatic, Right Upper Extremity to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System7 Lymphatic and Hemic Systems
OperationT Resection
Body Part3 Lymphatic, Right Upper Extremity
Approach4 Percutaneous Endoscopic
DeviceZ No Device
QualifierZ 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, Right Upper Extremity

Lymph nodes of the right upper extremity, concentrated along the brachial and cubital chains, drain the arm, forearm, and hand and are resected chiefly when melanoma or another skin cancer of the limb has spread to regional nodes, or occasionally when isolated lymphadenopathy requires excisional biopsy for diagnosis. Because these nodes are fewer and more dispersed than axillary nodes, resection is usually a targeted excision of a specific palpable or imaging-identified node rather than an extensive nodal basin dissection. Care is taken to avoid the brachial vessels and major nerves of the arm that travel alongside these lymphatic channels. Coders should distinguish this body part from axillary lymphatic resection on the same side, since the two are separately valued procedures despite both draining the same limb and sometimes being performed together.

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.

Commonly Confused With

ExcisionResection is most often confused with Excision, where only part of the body part is cut out; the total-versus-partial distinction is the deciding factor.
DetachmentIt is also distinguished from Detachment, which applies to limbs rather than lymphatic structures, and from Extirpation, which removes abnormal matter such as a clot or foreign material rather than the body part itself.