0BT50ZZ
Resection Middle Lobe Bronchus, Right 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 | 5 Middle Lobe Bronchus, Right |
| 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
Middle Lobe Bronchus, Right
The middle lobe bronchus is the smallest and narrowest of the right-sided lobar airways, arising from the bronchus intermedius to ventilate the right middle lobe alone. Its narrow caliber makes it particularly prone to obstruction from tumor, mucus plugging, or extrinsic compression by adjacent lymph nodes, and resection of this bronchus is usually undertaken for a localized endobronchial lesion or as part of a bronchoplastic procedure sparing the rest of the lung. Because the middle lobe bronchus is short and closely bordered by the upper and lower lobe orifices, even a small resection carries a real risk of narrowing neighboring airways during reconstruction. Documentation should make clear that the excised tissue was the bronchial segment itself, distinguishing this procedure from a middle lobectomy involving the lung parenchyma.
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.