0NT50ZZ
Resection Temporal Bone, Right to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | N Head and Facial Bones |
| Operation | T Resection |
| Body Part | 5 Temporal Bone, 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 procedures on the head and facial bones involve cutting out and removing an entire bone or bony structure, such as an entire orbit, zygoma, or portion of the mandible, without replacing it with anything at the time of the procedure. This differs from simply trimming or shaving bone; the whole named body part is taken out. Surgeons choose this route most often to remove a tumor that has invaded bone, to eliminate bone destroyed by severe infection, or to address extensive trauma where the bone cannot be salvaged.
Head and neck cancer surgery accounts for a large share of these procedures, including mandibulectomy for oral cancer or orbital exenteration involving bony structures for advanced tumors of the eye or sinuses. Because facial bones support speech, chewing, breathing, and appearance, resection is usually followed later by reconstructive procedures, though the resection itself is coded as a standalone event focused purely on removal.
Patients considering these procedures typically undergo extensive imaging and staging beforehand, and recovery involves both physical healing and adaptation to the functional changes that come with losing a facial or cranial bone.
Anatomy & Axis Detail
Temporal Bone, Right
The right temporal bone is a complex structure housing the middle and inner ear, the mastoid air cells, and portions of the carotid canal and jugular foramen, making it one of the most anatomically intricate bones addressed in this body system. Resection of the entire bone is performed almost exclusively for extensive malignancy, such as squamous cell carcinoma invading the temporal bone, or severe destructive chronic infection unresponsive to lesser procedures, and it carries substantial risk to hearing, facial nerve function, and adjacent vascular structures. Because the facial nerve courses directly through this bone, its preservation or sacrifice is a central consideration during resection and should be clearly documented, along with management of the sigmoid sinus and dura, which are frequently exposed during complete removal.
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
A resection code applies only when documentation confirms the entire bone or the entire named body part in the ICD-10-PCS table is excised, not a partial segment. Operative reports should specify the bone removed in full, such as total mandibulectomy or complete removal of the zygomatic arch, and should distinguish this from partial bone removal, which falls under Excision instead. Pathology reports describing tumor margins and the extent of bony involvement often support the medical necessity and the completeness of removal.
The most common coding mistake is applying Resection when only part of a facial bone was taken, which should instead be coded as Excision; PCS root operations hinge on whether "all" or only "a portion" of the body part was removed, so precise reading of the operative note matters more than the common name of the procedure. Another frequent error is overlooking a same-session reconstruction, which requires an additional code such as Replacement or Supplement rather than assuming the resection code covers everything performed.