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Resection Superior Parathyroid Gland, Left to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | G Endocrine System |
| Operation | T Resection |
| Body Part | M Superior Parathyroid Gland, 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 in the endocrine system means the complete surgical removal of a gland such as the thyroid, a parathyroid gland, an adrenal gland, or the pituitary, without any replacement structure put in its place. It is one of the most frequently performed procedures in endocrine surgery because so many endocrine conditions, from cancer to hormone-secreting tumors to autoimmune overactivity, are best treated by taking the entire gland out.
Common reasons include thyroid cancer or a large multinodular goiter, Graves' disease that has not responded to medication, a parathyroid adenoma causing hyperparathyroidism, an adrenal tumor such as a pheochromocytoma, or a pituitary tumor removed through the skull base. Because these glands regulate metabolism, blood pressure, calcium balance, and stress hormones, patients undergoing resection typically need lifelong hormone replacement or monitoring afterward, which their care team discusses well before surgery.
Anatomy & Axis Detail
Superior Parathyroid Gland, Left
The left superior parathyroid gland occupies a position near the upper posterior thyroid lobe on the opposite side from its right-sided counterpart, and its resection is coded separately to reflect the distinct laterality of the procedure. Surgeons pursue removal of this specific gland when imaging or biochemical testing localizes a functioning adenoma to the left superior position, sparing the remaining normal glands to preserve calcium homeostasis. Because superior parathyroid glands develop from the fourth pharyngeal pouch and tend to sit in a more predictable location than inferior glands, targeted excision is often feasible through a focused, minimally invasive approach. Intraoperative hormone assays are typically used to verify that resecting this single left-sided gland has resolved the hyperparathyroidism.
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 confirm the entire gland was removed, not a lobe, nodule, or partial gland, since a partial removal is coded as excision instead. When a total thyroidectomy is performed in stages or as completion surgery after a prior partial removal, coders need to check whether any residual tissue remained from the earlier operation and code accordingly. A common mistake is coding bilateral adrenalectomy or parathyroidectomy as a single procedure when each gland is a separate body part value requiring its own code. Coders should also watch for cases where a resection is combined with a separate reconstructive or reconstructive-adjacent step, such as autotransplantation of a parathyroid gland fragment, which requires an additional code.