ICD-10-PCS Billable Code

0LTD4ZZ

Resection Thorax Tendon, Left to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemL Tendons
OperationT Resection
Body PartD Thorax Tendon, Left
Approach4 Percutaneous Endoscopic
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Cutting out or off, without replacement, all of a body part

Procedure Overview

Resection removes an entire tendon, or a clearly defined tendon body part, without putting in any replacement material. This is a less common tendon procedure than repair or reposition, and it is typically performed when a tendon is so severely diseased, degenerated, or tumor-involved that removing it entirely is the safest or most effective option, rather than attempting to preserve and repair it.

Examples include excising a tendon segment infiltrated by a soft tissue tumor, removing a chronically diseased tendon that is causing ongoing pain and dysfunction with no reasonable prospect of repair, or excising an entire tendon as part of managing a severe infection that has destroyed the tissue. Because tendons connect muscle to bone, complete resection without any subsequent reconstruction can leave a functional deficit, so it is often paired with a separate reconstructive procedure, sometimes performed later, to restore movement.

Anatomy & Axis Detail

Thorax Tendon, Left

On the left thorax, the tendinous structures binding chest wall musculature to the rib cage and sternum sit adjacent to the heart's lateral border, which makes complete resection of one of these tendons a more anatomically sensitive undertaking than its right-sided counterpart. Indications mirror those on the right - a neoplasm, chronic infected tissue, or a tendon rendered nonviable by trauma or prior surgery - but the proximity to mediastinal structures often shapes the surgical approach and the extent of exposure needed. Full resection removes the tendon in its entirety at its native boundaries, distinguishing it from a partial excision. Because the left thorax overlies critical intrathoracic organs, surgeons and coders alike need precise anatomic detail confirming that only the tendon, not surrounding muscle, pleura, or bone, was taken, since imprecise operative notes can blur the line between Resection, Excision, and Detachment.

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

This root operation applies only when an entire named tendon body part, not merely a segment or the whole tendon down to its full anatomic extent, is being cut out and nothing biological or synthetic is placed to take its structural role. Coders should confirm the operative note describes complete excision of the tendon at that body part value, and check whether any reconstructive graft was placed at the same time, since combined excision and grafting is coded as Replacement instead.

A common assignment mistake is applying Resection when only part of a tendon was removed and the remaining tendon was repaired or trimmed, which should instead be coded as Excision or Repair depending on the amount and intent of tissue removed. Coders should also watch for tumor cases where a wider excision spans tendon and adjacent soft tissue, which may require coding to more than one body system.

Commonly Confused With

ExcisionResection is frequently confused with Excision, since both remove tendon tissue; the distinguishing factor is completeness, Resection takes the entire tendon body part while Excision removes only a portion of it.
ReplacementIt is also confused with Replacement when a tumor resection is immediately followed by grafting to rebuild the tendon, in which case the excision and reconstruction should be captured as two distinct procedures rather than one combined code.