ICD-10-PCS Billable Code

0YU14KZ

Supplement Buttock, Left to No Qualifier with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemY Anatomical Regions, Lower Extremities
OperationU Supplement
Body Part1 Buttock, Left
Approach4 Percutaneous Endoscopic
DeviceK Nonautologous Tissue Substitute
QualifierZ No Qualifier

Operation Definition

Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a body part

Procedure Overview

Supplement procedures in this family involve placing biological or synthetic material into or onto a lower extremity anatomical region to physically reinforce or add bulk to existing tissue, rather than to replace missing structure. Surgical mesh used to reinforce weakened fascia or a defect in the leg or foot region, or an autologous or donor graft layered onto tissue to strengthen it, are typical examples.

This type of procedure is chosen when the body part is present and largely intact but needs additional support to hold its shape, resist strain, or heal properly, such as reinforcing a soft-tissue closure after trauma or a prior surgical repair. It differs from simply closing or repairing a wound because material is deliberately added to bolster the area beyond what the patient's own tissue can currently provide.

Anatomy & Axis Detail

Buttock, Left

In the left buttock, supplement procedures augment gluteal soft tissue that has been thinned by chronic pressure ulceration, prior debridement, or age-related atrophy, using grafts or synthetic material to restore contour and provide cushioning over the ischial tuberosity and sacrum. The gluteal region's substantial muscle mass makes it a common recipient site for autologous fat grafting or acellular dermal matrix placement aimed at reinforcing tissue that remains structurally present but functionally deficient. Because supplement adds material rather than removing or replacing the native body part, clear documentation of the graft or device type, along with the specific layer reinforced, is essential to distinguish this procedure from repair of an open wound or replacement of missing tissue.

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.

Device: Nonautologous Tissue Substitute

Nonautologous Tissue Substitute refers to biologic material sourced from a donor or another species, such as an allograft or xenograft, used to replace a body part. It differs from Autologous Tissue Substitute by tissue origin outside the patient's own body, and from Synthetic Substitute by being biologic rather than manufactured material.

Coding & Documentation

A coder assigns Supplement when documentation shows material was added to reinforce or augment a body part that remains present, with the graft or mesh serving a support function rather than substituting for an absent structure. The note should specify the material used, whether autograft, allograft, or synthetic mesh, since device and substance qualifiers affect code selection. A common error is coding Supplement when the material is actually replacing a resected or absent structure, which belongs to Replacement instead, or coding Repair when reinforcing material was in fact placed, which should be captured as Supplement.

Commonly Confused With

ReplacementSupplement is most often confused with Replacement, but Replacement substitutes for a body part that is absent or has been taken out, while Supplement reinforces a body part that remains in place.
RepairIt is also distinguished from Repair, since Repair restores tissue using the patient's own structure without adding reinforcing material.
InsertionInsertion is a related but separate concept, used when a device is placed to monitor, assist, or perform a function rather than to physically reinforce tissue.