0QT60ZZ
Resection Upper Femur, Right 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 | 6 Upper Femur, 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
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
Upper Femur, Right
The upper (proximal) femur on the right comprises the femoral head, neck, and greater and lesser trochanters, the region that forms the ball of the hip joint and anchors the major hip abductor and flexor musculature. Resection removes this entire segment, most often for primary bone sarcomas, extensive metastatic involvement, chronic osteomyelitis unresponsive to debridement, or catastrophic fracture with bone loss that precludes fixation. Because the proximal femur is central to hip stability and gait, its removal is almost always paired with a proximal femoral replacement prosthesis to preserve limb function. Coding this procedure requires distinguishing it from excision of a lesser portion, and from replacement codes that capture the reconstructive component performed alongside or after the bony resection.
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.