0QTR0ZZ
Resection Toe Phalanx, Left to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | Q Lower Bones |
| Operation | T Resection |
| Body Part | R Toe Phalanx, 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
This family covers the surgical removal of an entire bone or bony structure in the leg, foot, pelvis, or related lower-body skeletal segment, without putting anything back in its place. It applies to structures such as the femur, tibia, fibula, patella, pelvic bones, tarsals, metatarsals, and toe phalanges. Surgeons turn to it when a bone segment is destroyed by infection, riddled with tumor, so badly fractured that repair isn't feasible, or deformed beyond what osteotomy or reshaping could correct.
Because resection takes out the whole named bony part rather than a fragment, it is a bigger step than excision or debridement. Patients encounter it most often in the context of bone cancer (primary or metastatic), chronic osteomyelitis that has not responded to antibiotics, or severe joint destruction where the diseased bone end must be cleared away before a prosthesis or graft can be placed. Depending on the site, the surgeon may reconstruct with a graft, implant, or amputation-level closure in a separate, later procedure.
Anatomy & Axis Detail
Toe Phalanx, Left
On the left foot, the toe phalanges are the short tubular bones of the digits, and entire resection of one is generally undertaken when infection, most commonly diabetic foot osteomyelitis, or a destructive lesion has compromised the bone beyond salvage with debridement alone. Because the phalanges are small and closely associated with overlying skin, nail, and tendon structures, resection here often occurs in the context of broader toe-sparing or partial amputation surgery, and the surgeon's documentation must clarify that the entire phalanx, rather than a fragment or joint surface, was excised. Specifying the affected toe and phalangeal segment (proximal, middle, or distal) is essential, since these are distinct anatomically and coded separately from full toe amputation.
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 note has to state that an entire named bony part was removed, not a portion of it - documentation reading "partial resection" or "removed a segment of the shaft" points instead to Excision. Coders should confirm the specific bone or bone group from the ICD-10-PCS body part table (e.g., distal femur vs. entire femur can carry different values) and check whether the pathology report or op note supports a diagnosis - like tumor or osteomyelitis - that clinically justifies total removal.
A frequent error is defaulting to Resection whenever a large piece of bone is taken, when the correct read is Excision if any portion of the bone remains. Another is missing a same-operative-session Replacement or Supplement, which should be coded separately if a graft or device is placed after the bone is removed.