0FL83DZ
Occlusion Cystic Duct to No Qualifier with Intraluminal Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | F Hepatobiliary System and Pancreas |
| Operation | L Occlusion |
| Body Part | 8 Cystic Duct |
| Approach | 3 Percutaneous |
| Device | D Intraluminal Device |
| Qualifier | Z No Qualifier |
Operation Definition
Completely closing an orifice or the lumen of a tubular body part
Procedure Overview
Occlusion procedures in this body system close off a duct, vessel, or opening within the liver, gallbladder, bile ducts, or pancreas so that fluid can no longer pass through it. This is most often performed on a bile duct or pancreatic duct that is leaking, diseased, or being deliberately sealed to redirect flow elsewhere, and less commonly on a blood vessel supplying these organs to stop bleeding or cut off circulation to a tumor.
Clinicians use this approach when a duct has been injured, is fistulizing to another structure, or needs to be sacrificed as part of a larger surgical plan, such as closing a stump left after partial removal of an organ. It may also be used to block blood flow into a tumor before resection, reducing bleeding risk during the main procedure.
The underlying idea is that the tubular structure remains anatomically in place but its lumen is deliberately shut, using clips, ligatures, embolic material, or a similar technique, rather than being cut out or repaired to restore normal function.
Anatomy & Axis Detail
Cystic Duct
The cystic duct connects the gallbladder to the common bile duct and is the structure most familiarly occluded during cholecystectomy, where it is clipped or ligated to prevent bile leakage and control the cystic artery pedicle before the gallbladder is separated from the liver bed. Occlusion of the cystic duct independent of gallbladder removal is less common but may be performed to manage a leak from a retained cystic duct stump or to close off a duct during a staged procedure. Its short length and variable insertion point into the common bile duct, sometimes running parallel to it for some distance, make correct identification essential, and operative documentation should be checked to ensure the closure was intentional and not simply a step within a broader cholecystectomy.
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 look for explicit documentation that a duct or vessel was ligated, clipped, coiled, embolized, or otherwise closed off completely, and confirm which specific structure and approach was used, since embolization performed percutaneously through interventional radiology is coded differently in device and approach values than a duct tied off during open surgery. The device value must reflect whether an extraluminal device such as a clip or ligature, or an intraluminal device such as a coil, was left in place.
A frequent error is confusing partial narrowing or compression of a duct with true occlusion, when the intent and result must be complete closure of the lumen. Another common mistake is coding Occlusion when the vessel or duct was actually cut and its ends tied off as an incidental part of a different procedure, such as division during a resection, in which case the occlusion is not coded separately.