ICD-10-PCS Billable Code

04LK4CZ

Occlusion Femoral Artery, Right to No Qualifier with Extraluminal Device, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System4 Lower Arteries
OperationL Occlusion
Body PartK Femoral Artery, Right
Approach4 Percutaneous Endoscopic
DeviceC Extraluminal Device
QualifierZ 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

Femoral Artery, Right

The femoral artery in the right thigh is the major conduit for arterial supply to the leg below the groin, and occlusion here is most often a deliberate embolization procedure used to treat a pseudoaneurysm, arteriovenous fistula, or bleeding vessel resulting from prior catheterization or trauma at this common access site. Coils, particles, or a covered stent may be used depending on whether flow through the native lumen must be preserved or the entire segment sealed, and the procedure is frequently performed under ultrasound or fluoroscopic guidance given how frequently this artery is punctured for other interventions. Because the femoral artery bifurcates into superficial and profunda branches nearby, precise localization of the occluded segment relative to this bifurcation is clinically important and should be reflected clearly in the procedural documentation.

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.

Device: Extraluminal Device

Extraluminal Device describes a device positioned on the outside surface of a tubular or hollow body part rather than within its lumen, such as a vascular banding or external stabilization device. It is the structural counterpart to Intraluminal Device, distinguished by its external placement relative to the vessel or duct wall rather than sitting inside the passageway itself.

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.

Commonly Confused With

RestrictionRestriction is the procedure most easily confused with Occlusion, since both narrow a vessel, but Restriction only partially reduces the diameter or flow while Occlusion eliminates it completely - the operative note's description of the intended endpoint is the deciding factor.
DestructionDestruction is another neighboring concept when tissue rather than a vessel lumen is being eliminated, and coders should check whether the artery itself was closed versus abnormal tissue fed by it being obliterated.