04LF3CU
Occlusion Internal Iliac Artery, Left to Uterine Artery, Left with Extraluminal Device, Percutaneous 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 | 3 Percutaneous |
| Device | C Extraluminal Device |
| Qualifier | U Uterine 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: 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: 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.
Qualifier: Uterine Artery, Left
In lower artery procedures, this qualifier identifies the left uterine artery as the specific vessel occluded or embolized, most often in uterine fibroid embolization performed to shrink fibroids by cutting off their blood supply. It distinguishes the left branch from the right uterine artery, which is coded separately since embolization is frequently done bilaterally in the same encounter.
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.