04L84ZZ
Occlusion Colic Artery, Middle to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 4 Lower Arteries |
| Operation | L Occlusion |
| Body Part | 8 Colic Artery, Middle |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Completely closing an orifice or the lumen of a tubular body part
Procedure Overview
Occlusion procedures on the lower arteries deliberately seal off a vessel's opening or lumen so blood can no longer pass through it. This is done using techniques like embolization coils, particles, or glue delivered through a catheter, or by surgically tying off the artery, and it serves purposes ranging from stopping dangerous bleeding to cutting blood supply to a tumor or an abnormal vascular connection. Unlike most procedures aimed at restoring flow, this family intentionally blocks it.
Common reasons for occlusion include controlling a bleeding vessel after trauma or during surgery, shrinking uterine fibroids by blocking their blood supply, treating an aneurysm by closing off the feeding artery, or managing internal bleeding from the gastrointestinal or pelvic arteries. The approach can be catheter-based and minimally invasive or performed as part of an open surgical procedure.
Anatomy & Axis Detail
Colic Artery, Middle
The middle colic artery, a branch of the superior mesenteric artery, supplies the transverse colon and is occluded most often as part of a transverse colectomy or extended right hemicolectomy performed for tumors located in this segment, since ligating the vessel is necessary to mobilize and remove the affected bowel along with its lymphatic drainage. This artery lies within the transverse mesocolon in close relation to the middle colic vein and the gastrocolic trunk, structures that require careful dissection to avoid inadvertent injury. Because the transverse colon sits at a watershed area between the superior and inferior mesenteric distributions, occlusion of the middle colic artery specifically raises the importance of confirming adequate collateral flow through the marginal artery before completing the resection.
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
Coders should look for clear language that the artery was closed off entirely - terms like embolization, coiling, ligation, or clipping - and confirm from the note that the intent and result was complete closure rather than partial narrowing. The specific artery occluded needs to match the correct body part value, which for pelvic and reproductive procedures like uterine fibroid embolization can involve multiple small branches. A frequent mistake is confusing partial narrowing intended to reduce but not eliminate flow with true occlusion, or missing that embolization material used therapeutically differs from diagnostic catheter placement, which would not be separately coded.