0BT70ZZ
Resection Main Bronchus, Left to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | B Respiratory System |
| Operation | T Resection |
| Body Part | 7 Main Bronchus, Left |
| Approach | 0 Open |
| 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
Main Bronchus, Left
The left main bronchus is notably longer and more horizontally angled than its right-sided counterpart, passing beneath the aortic arch before dividing into upper and lower lobe bronchi, an anatomic relationship that adds surgical complexity when disease approaches the aorta or pulmonary artery. Resection is typically performed for a centrally situated bronchogenic tumor or a benign stricture, with the greater length of the left main bronchus sometimes allowing more room for a tension-free end-to-end anastomosis than is possible on the right. Because of its proximity to major mediastinal vessels, careful dissection is required to avoid vascular injury during mobilization. Coding should reflect that the excised segment was the bronchus itself, with any concurrent lung tissue removal captured separately if the operative note documents extension beyond the airway.
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.