0UT28ZZ
Resection Ovaries, Bilateral to No Qualifier with No Device, Via Natural or Artificial Opening Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | T Resection |
| Body Part | 2 Ovaries, Bilateral |
| Approach | 8 Via Natural or Artificial Opening 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 describes the complete surgical removal of an entire female reproductive organ or defined anatomic part, without any replacement. Hysterectomy, salpingectomy, and oophorectomy are the procedures patients most commonly associate with this family, performed for conditions ranging from cancer and fibroids to endometriosis, chronic pain, or as a preventive measure against hereditary cancer risk.
Because Resection means the entire body part is taken out rather than a portion of it, the distinction from partial removal matters clinically and surgically. A total hysterectomy removes the whole uterus, while a partial or supracervical hysterectomy leaves the cervix behind, changing both the postoperative anatomy and the code assigned. The approach used, open abdominal, laparoscopic, robotic-assisted, or vaginal, also affects surgical planning and recovery but is captured separately from the root operation itself.
Anatomy & Axis Detail
Ovaries, Bilateral
Bilateral resection removes both ovaries in a single operative episode, eliminating the body's primary source of oocytes and the majority of circulating estrogen and progesterone. This is performed for bilateral ovarian tumors, severe endometriosis affecting both adnexa, or prophylactically in women with BRCA mutations or Lynch syndrome once childbearing is complete, often paired with salpingectomy as a risk-reducing bilateral salpingo-oophorectomy. Because removing both ovaries induces surgical menopause in premenopausal patients, the decision carries hormonal and bone-health implications that are typically discussed before consent. Coding this as a single bilateral value applies only when both ovaries are excised in the same operative episode through the same or a similar approach; if performed at different times or through different approaches, each side is coded individually rather than combined.
Approach: Via Natural or Artificial Opening Endoscopic
Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.
Coding & Documentation
Coders assign Resection when the operative note confirms an entire organ or anatomically whole body part was removed, such as total hysterectomy, bilateral salpingo-oophorectomy, or complete cervical excision. The pathology report and operative note together should confirm what specifically was taken, since PCS body part values distinguish between the uterus, cervix, ovaries, and fallopian tubes as separate structures each requiring their own code when removed.
A common error is coding a single combined value when bilateral organs are removed through separate steps, or failing to code each structure that was resected individually, such as coding only the hysterectomy and overlooking a concurrent oophorectomy. Coders should also watch for cases described as "debulking" or "cytoreduction," which may include a mix of Resection and Excision depending on whether entire organs or only portions of tissue were removed.