0MTC4ZZ
Resection Upper Spine Bursa and Ligament to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | T Resection |
| Body Part | C Upper Spine Bursa and Ligament |
| Approach | 4 Percutaneous Endoscopic |
| 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 in this family involve cutting out an entire bursa or ligament without replacing it, typically because the structure has become a source of chronic pain, inflammation, or dysfunction that outweighs its remaining usefulness. A classic example is bursectomy for chronic olecranon or prepatellar bursitis that has failed conservative treatment, where the inflamed bursal sac is excised in its entirety rather than drained or repaired.
Surgeons pursue full resection when a bursa is persistently infected, calcified, or thickened, or when a ligament is so degenerated or contributing to impingement that removing it altogether is more beneficial than attempting repair. Unlike partial excisions performed to biopsy or debride tissue, resection removes the whole named structure. Patients typically recover well because bursae and many accessory ligaments are not essential to joint function once inflammation is resolved.
Anatomy & Axis Detail
Upper Spine Bursa and Ligament
The upper spine bursa and ligament category encompasses the ligaments stabilizing the cervical and upper thoracic vertebrae, including the anterior and posterior longitudinal ligaments, ligamentum flavum, and interspinous ligaments, along with any associated paraspinal bursae. Resection of these structures is performed when ossification, such as ossification of the posterior longitudinal ligament, or severe degenerative thickening compresses the spinal cord or nerve roots, requiring surgical removal to relieve neurologic symptoms. Because these ligaments lie in close proximity to the spinal canal and cervical spinal cord, resection is a high-stakes procedure typically performed alongside decompressive surgery, and surgeons must balance thorough excision against the risk of destabilizing the cervical spine. Precise documentation of the vertebral level and ligament involved is essential given the neurologic risk inherent to this anatomic region.
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
A coder selects Resection when the documentation confirms complete removal of an entire bursa or ligament, not just a portion, and no replacement or graft material is used. Look for terms such as "bursectomy," "complete excision," or "ligament removed in its entirety." A common error is applying Resection when only part of the structure was taken, which should instead be coded as Excision, a distinct root operation reserved for partial removal. Coders also need to verify that removal was not a preliminary step to a Replacement procedure performed in the same operative episode, which would require separate coding.