047A37Z
Dilation Renal Artery, Left to No Qualifier with Intraluminal Device, Drug-eluting, Four or More, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 4 Lower Arteries |
| Operation | 7 Dilation |
| Body Part | A Renal Artery, Left |
| Approach | 3 Percutaneous |
| Device | 7 Intraluminal Device, Drug-eluting, Four or More |
| 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
Renal Artery, Left
The left renal artery supplies the left kidney and is a common site of stenosis from atherosclerotic plaque, typically at its aortic origin, or from fibromuscular dysplasia, which more often affects its mid and distal segments. Dilation restores luminal diameter to address hypertension refractory to medical therapy or to protect kidney function when stenosis threatens perfusion, using balloon inflation with adjunctive stent placement when elastic recoil or dissection risk warrants it. The left renal artery is generally longer than the right and crosses anterior to the aorta at a more direct angle, which can simplify catheter engagement. Operative reports should specify lesion location and any device left in place, since ostial versus truncal disease and stent use both influence the complete procedure code.
Approach: Percutaneous
Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.
Device: Intraluminal Device, Drug-eluting, Four or More
Four or More Drug-eluting Intraluminal Devices captures procedures in which four or more such devices, commonly coronary stents, are implanted in the same body part in one session. It represents the upper end of the drug-eluting device-count scale, distinguished from the Two and Three counts only by quantity, and from the non-drug-eluting four-or-more value by the presence of a pharmacologic coating.
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.