0TL44CZ
Occlusion Kidney Pelvis, Left to No Qualifier with Extraluminal Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | T Urinary System |
| Operation | L Occlusion |
| Body Part | 4 Kidney Pelvis, Left |
| Approach | 4 Percutaneous Endoscopic |
| Device | C Extraluminal Device |
| Qualifier | Z No Qualifier |
Operation Definition
Completely closing an orifice or the lumen of a tubular body part
Procedure Overview
Occlusion procedures close off a urinary structure completely, most often a ureter, so that urine or another substance can no longer pass through it. This is done when a ureter must be sealed off because of an unrepairable fistula, a nonfunctioning kidney left in place, or a urinary diversion in which the natural path from kidney to bladder is intentionally interrupted. The occlusion can be achieved surgically by ligating or clipping the ureter, or by placing material inside the vessel to block flow.
Patients who undergo this procedure often have advanced disease affecting kidney function or urinary drainage, such as a kidney destroyed by long-standing obstruction, and the goal is to prevent urine leakage or infection rather than to restore normal function.
Anatomy & Axis Detail
Kidney Pelvis, Left
The left kidney pelvis collects urine from the calyces before it drains into the left ureter, and its position adjacent to the spleen and splenic flexure of the colon can influence percutaneous access planning compared with the right side. Occlusion of this structure is used to intentionally halt urine passage, for example to control a persistent leak, isolate a segment before resection, or manage reflux, and it is usually carried out endoscopically or percutaneously with a balloon, plug, or embolic coil rather than through open ligation. Documentation specifies the left side because instrumentation trajectory, imaging landmarks, and postprocedural monitoring differ from the contralateral kidney, and because bilateral procedures are coded and tracked separately from unilateral ones.
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 confirm from the operative note that the intent was complete closure of the lumen, not narrowing or repair, since Occlusion requires that no material can pass through afterward. Documentation should specify the exact segment of ureter closed and the method used, whether suture ligation, clipping, or an endoluminal occluding device, because the approach value depends on how access was gained.
A common mistake is confusing occlusion with Restriction, which only partially narrows a lumen rather than closing it entirely; if any flow is still possible, Restriction is the correct root operation instead. Another frequent error is coding an occlusion performed as part of a larger diversion or nephrectomy procedure as a separate line item when it was an integral step of that more comprehensive procedure and should not be coded independently.
Commonly Confused With
This family is most often confused with Restriction, since both narrow a tubular structure, and with an incidental ligation performed as a step of another procedure. The key distinction from Restriction is whether the lumen is completely closed versus only partially narrowed. The distinction from an incidental ligation is whether closing the ureter was the primary objective of the procedure or merely a technical step within a more extensive operation such as a nephroureterectomy, in which case it is not coded separately.