0LXJ4ZZ
Transfer Hip Tendon, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | X Transfer |
| Body Part | J Hip Tendon, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion of a body part
Procedure Overview
Tendon transfer procedures move a functioning tendon, along with its muscle attachment, from its original insertion point to a new location so it can take over a movement that has been lost due to nerve injury, muscle paralysis, or irreparable tendon damage elsewhere. The tendon is not removed from the body; it is rerouted while keeping its blood supply and nerve connection intact.
This approach is used when restoring the original damaged tendon is not possible or would not regain function, such as after a peripheral nerve injury that has left a muscle group permanently unable to fire, or in longstanding rotator cuff tears where the original muscle-tendon unit is no longer viable. A classic example is transferring a wrist flexor tendon to restore finger extension after radial nerve palsy.
Because the transferred tendon must learn a new job, rehabilitation includes retraining the patient to consciously activate the muscle for its new purpose, in addition to standard healing time.
Anatomy & Axis Detail
Hip Tendon, Right
Hip tendons on the right include insertions such as the iliopsoas, gluteal tendons, and adductor tendons that cross the hip joint to control flexion, extension, abduction, and rotation. A right hip tendon transfer relocates one of these insertions, with its vascular and neural supply preserved, to substitute for a muscle group that has lost function, a technique applied in cases of hip abductor deficiency, certain neuromuscular gait disorders, or after tumor resection involving the proximal femur or pelvis. Because the hip is a deep, multiplanar joint with several tendons converging near the greater trochanter and lesser trochanter, precise identification of the donor tendon and its new attachment site is critical, and right-sided laterality must be clearly documented to avoid confusion with the contralateral procedure.
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
Correct code assignment depends on documentation identifying both the tendon that was moved and the body part whose function it is now taking over, since ICD-10-PCS captures the qualifier for the new functional purpose. The operative note should describe the tendon's original attachment, its new insertion site, and confirm that it retained its native blood and nerve supply throughout the move.
A common mistake is coding a tendon transfer as Transplantation, which applies only when tissue from another individual or a different body site is used with no native vascular connection preserved. Another frequent error is failing to capture the qualifier value that reflects the body part whose function is being restored, since Transfer in ICD-10-PCS requires specifying what the moved tendon is now accomplishing.