0MTG4ZZ
Resection Rib(s) Bursa and Ligament to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | T Resection |
| Body Part | G Rib(s) Bursa and Ligament |
| 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 procedures in this family involve cutting out an entire bursa or ligament without replacing it, typically because the structure has become a source of chronic pain, inflammation, or dysfunction that outweighs its remaining usefulness. A classic example is bursectomy for chronic olecranon or prepatellar bursitis that has failed conservative treatment, where the inflamed bursal sac is excised in its entirety rather than drained or repaired.
Surgeons pursue full resection when a bursa is persistently infected, calcified, or thickened, or when a ligament is so degenerated or contributing to impingement that removing it altogether is more beneficial than attempting repair. Unlike partial excisions performed to biopsy or debride tissue, resection removes the whole named structure. Patients typically recover well because bursae and many accessory ligaments are not essential to joint function once inflammation is resolved.
Anatomy & Axis Detail
Rib(s) Bursa and Ligament
The rib bursae and ligaments include the costotransverse, costovertebral, and radiate sternocostal ligaments that stabilize each rib's articulation with the vertebra and sternum, along with small adjacent bursae that reduce friction during respiratory motion. Resection of this tissue is undertaken when a ligament is chronically inflamed, calcified, or involved by a tumor extending along the chest wall, or when scarred costovertebral tissue is contributing to intercostal nerve entrapment and pain. Because these structures sit close to the pleura and neurovascular bundle running along the rib's inferior border, complete excision requires careful dissection to avoid pneumothorax or intercostal nerve injury. The procedure is coded by the specific rib level involved, and documentation should clarify whether the excised tissue was entirely removed rather than merely debrided, since partial removal is coded differently.
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
A coder selects Resection when the documentation confirms complete removal of an entire bursa or ligament, not just a portion, and no replacement or graft material is used. Look for terms such as "bursectomy," "complete excision," or "ligament removed in its entirety." A common error is applying Resection when only part of the structure was taken, which should instead be coded as Excision, a distinct root operation reserved for partial removal. Coders also need to verify that removal was not a preliminary step to a Replacement procedure performed in the same operative episode, which would require separate coding.