047645Z
Dilation Colic Artery, Right to No Qualifier with Intraluminal Device, Drug-eluting, Two, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 4 Lower Arteries |
| Operation | 7 Dilation |
| Body Part | 6 Colic Artery, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | 5 Intraluminal Device, Drug-eluting, Two |
| Qualifier | Z No Qualifier |
Operation Definition
Expanding an orifice or the lumen of a tubular body part
Procedure Overview
This family describes procedures that widen a narrowed or blocked segment of an artery in the leg, pelvis, or abdomen so blood can flow more freely to the tissues those vessels supply. Narrowing in these arteries is commonly caused by atherosclerotic plaque buildup, and when it becomes severe enough, patients may experience leg pain with walking, poor wound healing, or in serious cases, tissue at risk of loss.
The procedure is typically performed using a catheter threaded through the vascular system to the narrowed spot, where a balloon is inflated to press the plaque outward and reopen the lumen. A stent is often left behind to help hold the artery open, though the dilation itself refers to the widening action rather than the device placement. Open surgical techniques that stretch a vessel are also included in this family.
These procedures are generally performed to relieve symptoms of peripheral artery disease, restore circulation to a limb, or address a stenosis found on vascular imaging, and are chosen based on how severe the narrowing is and how much of the artery is affected.
Anatomy & Axis Detail
Colic Artery, Right
The right colic artery arises from the superior mesenteric artery (or a common trunk with the ileocolic) and supplies the ascending colon, an area vulnerable to atherosclerotic narrowing in mesenteric ischemic disease. Dilation here widens the vessel lumen, typically via balloon angioplasty with or without an intraluminal device, to restore flow to the right colon when chronic mesenteric ischemia or a focal stenosis threatens bowel viability. Because the vessel is small-caliber and arises at a variable angle from the SMA, catheter access and device sizing are technically demanding. Documentation should specify whether the approach was open or percutaneous and whether a stent or other device was deployed, since these details affect code selection beyond the root operation and body part value.
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: Intraluminal Device, Drug-eluting, Two
This value specifies that exactly two drug-eluting intraluminal devices, such as coronary stents, were deployed within the same body part during one procedure. The device count matters for procedural coding because it reflects added technical complexity compared to a single drug-eluting device, and it is distinguished from the Three and Four or More counts by the specific number placed.
Coding & Documentation
Coders need documentation identifying the specific lower artery segment dilated, the approach used (open, percutaneous, or percutaneous endoscopic), and whether a device such as a stent or an intraluminal device was left in place, since that determines the device value appended to the code. The number of separate lesions treated in different named vessels can also affect how many codes are reported.
A common error is failing to code a separate Dilation for each distinct body part when multiple sites along the same limb are treated, since ICD-10-PCS defines body part values by specific artery segment. Another frequent mistake is omitting or misselecting the device value when a drug-eluting stent, a bare stent, or no device at all was used, since the operative note's wording on device type must be matched precisely to the code table options.