ICD-10-PCS Billable Code

0MXG4ZZ

Transfer Rib(s) Bursa and Ligament to No Qualifier with No Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemM Bursae and Ligaments
OperationX Transfer
Body PartG Rib(s) Bursa and Ligament
Approach4 Percutaneous Endoscopic
DeviceZ No Device
QualifierZ 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

Transfer procedures in this family move a bursa or ligament, or a portion of one, from its native location to a new site so it can take over the mechanical job normally performed by a different structure, without detaching its original blood and nerve supply. This is most often seen in tendon transfer surgery involving ligamentous tissue used to restore function after nerve injury, chronic tendon rupture, or joint instability where the original stabilizing structure can no longer do its job.

Because the tissue stays connected to its native blood supply, these procedures differ from a graft, which is fully detached and moved elsewhere. Surgeons choose this approach when a nearby ligament or bursal structure is healthy enough to be rerouted and can plausibly substitute for a damaged one, offering better long-term durability than an artificial replacement in select patients.

Anatomy & Axis Detail

Rib(s) Bursa and Ligament

The ligaments and bursae associated with the ribs, including the costovertebral and costotransverse ligaments, secure each rib to the vertebral column while permitting the rotational movement essential to breathing. A transfer procedure here repositions a vascularized segment of this ligamentous tissue to reinforce or substitute for a structure elsewhere in the thoracic cage, a technique that may be incorporated into chest wall reconstruction after trauma or resection. Because the ribs and their ligaments lie adjacent to the pleura and thoracic viscera, any tissue transfer in this region requires meticulous surgical planning to protect underlying structures. Coding accuracy depends on the operative note specifying exactly which rib-associated ligament was mobilized and where that tissue was directed to restore function.

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 code from this family applies when documentation clearly shows tissue being rerouted to a new location while remaining attached to its vascular pedicle, with the explicit intent of taking over another structure's function. The operative report should name both the origin site and the new destination, along with the functional deficit being addressed. Coders frequently misassign these cases as Transplantation, which requires the tissue to be completely freed from its original site, or as Repair, when the surgeon has simply reattached tissue back to its original position rather than relocating it to serve a new purpose.

Commonly Confused With

TransplantationThe closest source of confusion is Transplantation, distinguished only by whether the vascular supply is preserved (Transfer) or severed and reestablished at the new site (Transplantation).
ReattachmentReattachment is another frequent mix-up, used when a structure is put back in its original anatomic location rather than moved to substitute for a different one.