X27635B
Dilation Subclavian Vein, Left to New Technology Group 11 with Intraluminal Device, Cell Impermeable, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | X New Technology |
| Body System | 2 Cardiovascular System |
| Operation | 7 Dilation |
| Body Part | 6 Subclavian Vein, Left |
| Approach | 3 Percutaneous |
| Device | 5 Intraluminal Device, Cell Impermeable |
| Qualifier | B New Technology Group 11 |
Operation Definition
Expanding an orifice or the lumen of a tubular body part
Procedure Overview
This family describes catheter-based procedures that widen a narrowed or blocked blood vessel using next-generation devices, most notably bioresorbable vascular scaffolds that prop the artery open and then gradually dissolve over months rather than remaining as permanent metal, the way a conventional stent does. Patients typically undergo this when a coronary artery has narrowed enough to restrict blood flow to the heart muscle, causing chest pain or increasing the risk of a heart attack.
The appeal of the newer scaffold technology is that once the vessel has healed and remodeled around it, no permanent foreign material remains, which proponents argue may allow the artery to regain more of its natural flexibility and reduce certain long-term complications tied to permanently implanted hardware.
Anatomy & Axis Detail
Subclavian Vein, Left
The left subclavian vein returns blood from the left arm into the central venous system and, similar to the right side, is susceptible to stenosis from long-term catheters, transvenous lead placement, or repeated venipuncture, which can produce arm swelling, collateral vein formation, or failure of a dialysis fistula that relies on this outflow pathway. Dilation with a new-technology balloon device is used to reopen the narrowed segment and restore central venous flow, typically performed via catheter access from the arm or a central approach with fluoroscopic guidance to navigate the vein's path near the thoracic duct and left brachiocephalic vein. Documentation should specify the left-sided laterality and confirm use of the specific new-technology device, since this distinguishes the procedure from conventional venoplasty and from dilation of the corresponding right-sided vessel.
Approach: Percutaneous
In New Technology, Percutaneous describes entry into the body via needle or instrument puncture through the skin or a mucous membrane, without a surgical incision, mirroring the same concept in Medical and Surgical. It is distinguished from Open access, which requires a full incision, and from Percutaneous Endoscopic, which adds visualization through the puncture site.
Device / Substance / Technology: Intraluminal Device, Cell Impermeable
This device value describes an intraluminal implant whose surface is engineered to block cell migration through it, preventing tissue ingrowth that could otherwise compromise the device or surrounding structure. It is distinguished from uncovered or cell-permeable intraluminal devices, which intentionally allow tissue integration. The cell-impermeable property is chosen when isolating a lumen from adjacent tissue response is the clinical goal.
Qualifier: New Technology Group 11
This qualifier designates Group 11, the most recent cohort at the time of its introduction, grouping technologies newly approved for New Technology section reporting in that fiscal year. Like every group value in this axis, it functions as an administrative marker rather than a description of the clinical intervention, which is captured elsewhere in the code. Its main point of confusion is with Group 10, the immediately preceding annual release.
Coding & Documentation
Correct code assignment depends on documentation identifying the specific scaffold or device material, the number of sites or vessels treated, and confirmation that the device qualifies under the applicable New Technology Approval Group rather than being a standard drug-eluting stent. A frequent error is undercounting the number of intraluminal devices deployed, or coding a bioresorbable scaffold placement under the standard Medical and Surgical dilation table simply because the physician's note used generic language like "stent" without specifying the technology.
Commonly Confused With
This family is easily confused with the standard Medical and Surgical coronary artery dilation table, since both describe widening a vessel with a catheter-delivered device. The distinguishing detail is the device itself, a scaffold formally recognized under New Technology criteria versus a conventional metal or drug-eluting stent, so the operative documentation of device type is what separates the two.