04LF0DW
Occlusion Internal Iliac Artery, Left to Prostatic Artery, Left with Intraluminal Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 4 Lower Arteries |
| Operation | L Occlusion |
| Body Part | F Internal Iliac Artery, Left |
| Approach | 0 Open |
| Device | D Intraluminal Device |
| Qualifier | W Prostatic Artery, Left |
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
Internal Iliac Artery, Left
The left internal iliac artery feeds the bladder, rectum, internal reproductive organs, and gluteal region, so occluding it is used to manage pelvic hemorrhage, exclude a hypogastric aneurysm, or eliminate backflow into an aneurysm sac being treated elsewhere in the iliac system. As with its right-sided counterpart, coils, plugs, or occasionally a covered stent are deployed endovascularly, and the procedure is frequently paired with external iliac artery stent-grafting during aortoiliac aneurysm repair to prevent a type II endoleak from persistent hypogastric flow. Rich collateral circulation from the contralateral internal iliac and lumbar arteries generally protects the pelvis from ischemia after occlusion, but coders should note whether the main trunk or an anterior/posterior division was targeted, since this distinction affects the specificity of the procedure captured.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
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.
Qualifier: Prostatic Artery, Left
This qualifier designates the left prostatic artery as the target vessel, used mainly in prostatic artery embolization for benign prostatic hyperplasia or, less often, hemorrhage control. It is paired with a matching right-sided qualifier, and together the two allow bilateral embolization to be captured as distinct procedures within the same operative episode.
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.