04LE3ZT
Occlusion Internal Iliac Artery, Right to Uterine Artery, Right with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 4 Lower Arteries |
| Operation | L Occlusion |
| Body Part | E Internal Iliac Artery, Right |
| Approach | 3 Percutaneous |
| Device | Z No Device |
| Qualifier | T Uterine Artery, Right |
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, Right
The right internal iliac artery supplies the pelvic viscera, gluteal muscles, and pelvic floor through its anterior and posterior divisions, making it a frequent target when bleeding, aneurysmal disease, or vascular malformation confined to the pelvis needs to be controlled without sacrificing limb perfusion. Occlusion is commonly performed with coils or a vascular plug delivered percutaneously, often as a staged step before endovascular aortic or iliac aneurysm repair to prevent retrograde filling of an excluded sac, or emergently to control postpartum or trauma-related pelvic hemorrhage. Its short trunk and rapid branching mean interventionalists must work close to the origin, and documentation should distinguish complete trunk occlusion from more selective branch-level control, since the extent of occlusion affects collateral pelvic blood supply and subsequent risk of ischemic complications.
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.
Qualifier: Uterine Artery, Right
Identifies the right uterine artery, a branch supplying the uterus, as the target of a procedure such as embolization for uterine fibroids or postpartum hemorrhage control. It is distinguished from the Prostatic Artery qualifiers, which apply to a different organ and sex-specific anatomy entirely, and laterality separates it from a corresponding left-sided approach when both sides are documented separately.
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.