ICD-10-PCS Billable Code

0QU207Z

Supplement Pelvic Bone, Right to No Qualifier with Autologous Tissue Substitute, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemQ Lower Bones
OperationU Supplement
Body Part2 Pelvic Bone, Right
Approach0 Open
Device7 Autologous 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 the lower bones add material - a mesh, graft, cement, or synthetic reinforcement - to strengthen or bulk up a bone that is still substantially present, rather than removing or replacing it outright. Typical uses include augmenting a thinning pelvic wall, reinforcing a healing fracture site, or filling a bone defect left after a benign lesion was scraped out.

Patients undergo this kind of procedure when a bone is structurally weak but does not need to be taken out - for example, bone grafting to fill a cavity, cement augmentation in osteoporotic bone before hardware placement, or mesh reinforcement over a thin cortical wall. The goal is to restore mechanical strength and support healing or subsequent hardware fixation, not to replace the bone's own tissue.

Anatomy & Axis Detail

Pelvic Bone, Right

The right pelvic bone, comprising the ilium, ischium, and pubis fused into a single structure, forms half of the bony pelvic ring and supports the hip joint along with the lower body's weight transfer to the legs. Supplement procedures address structural deficiency after tumor resection, severe fracture with bone loss, or acetabular defects encountered during revision hip surgery, using bone graft, synthetic augments, or mesh to rebuild missing pelvic bone stock. Given the pelvis's role anchoring both the axial skeleton and the hip, and its proximity to major vessels and the lumbosacral plexus, augmentation is often performed alongside internal fixation, and documentation should clarify that the procedure added material to reinforce existing bone rather than replacing the joint surface itself.

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.

Device: Autologous Tissue Substitute

Autologous Tissue Substitute identifies a device value where material harvested from the patient's own body, such as an autograft, is used to replace or reconstruct a body part. Its defining feature is tissue origin from the patient, setting it apart from Nonautologous Tissue Substitute, sourced from a donor or animal, and Synthetic Substitute, made of manufactured material.

Coding & Documentation

Coders need documentation confirming that the patient's own bone structure remained in place and that material was added to reinforce or augment it - autograft, allograft, synthetic bone substitute, or cement all qualify, and the specific substance often drives the correct device value. The material must physically bolster the existing bone rather than simply fill dead space cosmetically.

A common mixup is coding Supplement when the correct root operation is Replacement, which applies only when the material takes over the entire function of a body part that has been made physically absent - if the bone itself was removed and replaced, that's Replacement, not Supplement. Another frequent error is missing a concurrent Excision or Repair code when the graft site was first debrided or an underlying fracture was fixed.

Commonly Confused With

ReplacementReplacement is the key distinction: it is used when the native body part is physically eliminated and a device takes its place, while Supplement reinforces bone that remains.
RepairRepair can be confused with Supplement when a bone defect is closed without added reinforcing material - if nothing is put in to augment strength, the correct root operation is usually Repair.
InsertionInsertion is different again, reserved for placing a device that monitors, assists, or performs a function without physically reinforcing the bone itself, such as certain internal fixation hardware coded outside this family.