06HC3DZ
Insertion Common Iliac Vein, Right to No Qualifier with Intraluminal Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 6 Lower Veins |
| Operation | H Insertion |
| Body Part | C Common Iliac Vein, Right |
| Approach | 3 Percutaneous |
| Device | D Intraluminal Device |
| Qualifier | Z No Qualifier |
Operation Definition
Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part
Procedure Overview
Insertion in this family covers placing a nonbiological device into a lower extremity or lower abdominal vein that monitors, assists, or supports venous function without replacing the vein itself. The most common example is placement of an inferior vena cava filter, a small metal device designed to trap blood clots traveling from the legs before they reach the lungs, typically used in patients who cannot take blood thinners or who have had a clot despite being on them.
Other examples in this category include placing a venous catheter intended to remain in place for monitoring or infusion access through a lower extremity vein, or positioning a temporary device used to support venous flow during another procedure. The device stays in the vein to perform an ongoing function, distinguishing it from a one-time intervention like removing a clot or reshaping the vessel.
These procedures are usually done percutaneously under imaging guidance, with the physician threading the device through a peripheral vein access point to its target location in the venous system.
Anatomy & Axis Detail
Common Iliac Vein, Right
The right common iliac vein forms from the union of the right internal and external iliac veins and ascends to join its left counterpart in forming the inferior vena cava, occupying a relatively favorable anatomic position that is not compressed by the overlying artery the way the left common iliac vein often is. Insertion procedures in this vessel commonly involve placement of catheters for central venous access, thrombolytic infusion in iliofemoral deep vein thrombosis, or components used during inferior vena cava filter or stent procedures. Its position slightly to the right of the midline and its more direct course make it a technically more accessible target than the left common iliac vein, and documentation should confirm right-sided involvement since laterality is separately coded.
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
Intraluminal Device denotes a single device, such as a stent or occlusion device, positioned within the lumen of a tubular body part like a vessel, duct, or airway to maintain patency or occlude flow. It carries no drug coating or radioactivity, distinguishing it from the drug-eluting, radioactive, and bioactive intraluminal device values, and from Extraluminal Device, which sits outside rather than inside the lumen.
Coding & Documentation
Coders should confirm that the documentation describes placing a device intended to stay in the vein and serve an ongoing monitoring, protective, or supportive function, such as an IVC filter, rather than a device used only during the procedure and then withdrawn. The specific vein and device type both need to be clear in the operative note, since filter placement in the inferior vena cava is coded differently depending on the exact body part value available.
A common error is coding Insertion for devices that are actually part of a different root operation, such as a stent used to hold a vein open, which is coded as Restriction or Dilation with a device value rather than a standalone Insertion. Coders should also watch for IVC filter retrieval performed later, which is a separate Removal procedure and not part of the original Insertion code, and should not be conflated with it even when both occur in the same patient's history.