02TM3ZZ
Resection Ventricular Septum to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 2 Heart and Great Vessels |
| Operation | T Resection |
| Body Part | M Ventricular Septum |
| Approach | 3 Percutaneous |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection in the heart and great vessels describes cutting out an entire body part with nothing put in its place. In this body system that most often means removing a defined anatomic segment, such as an atrial appendage, or excising an entire structure that has become diseased or is no longer needed.
This differs from trimming away a portion of tissue; Resection applies to a complete structure being taken out, not a partial removal. Reasons for performing it range from eliminating a source of dangerous blood clots, as with an atrial appendage tied to stroke risk in atrial fibrillation, to removing a segment that is obstructing normal circulation or that was created for an earlier stage of treatment and is no longer required.
Because the heart and great vessels have a limited number of discrete, whole body parts recognized in this classification, true Resection procedures here are less common than in other body systems where whole organs are removed.
Anatomy & Axis Detail
Ventricular Septum
The ventricular septum is the thick muscular and membranous wall dividing the left and right ventricles, and its resection is performed to remove hypertrophied muscle causing left ventricular outflow tract obstruction, as in septal myectomy for hypertrophic obstructive cardiomyopathy, or to excise septal tissue involved by tumor. Because the septum contains portions of the conduction system, including the bundle of His near its membranous portion, resection requires precise localization to avoid inducing heart block. The muscular septum's thickness allows a defined wedge of tissue to be removed to widen the outflow tract, distinguishing this procedure from simple excision or repair of septal defects, which instead close an opening rather than remove bulk tissue. Septal resection is typically performed through the aortic valve or via a ventriculotomy depending on the approach chosen.
Approach: Percutaneous
Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.
Coding & Documentation
Coders should assign Resection here only when the documentation confirms an entire body part, as defined in the body part table, was removed and nothing was left in that location. If any portion of the structure remains, the correct root operation is usually Excision instead, so the note needs to be explicit about complete removal.
A frequent error is defaulting to Resection whenever a heart structure is cut out, without checking whether the body part is defined as a discrete whole entity in this body system. Left atrial appendage occlusion or excision procedures are a common source of this confusion, since some techniques resect the appendage while others merely close it off, which is a different root operation entirely.