0BL33ZZ
Occlusion Main Bronchus, Right to No Qualifier with No Device, Percutaneous Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | B Respiratory System |
| Operation | L Occlusion |
| Body Part | 3 Main Bronchus, Right |
| Approach | 3 Percutaneous |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Completely closing an orifice or the lumen of a tubular body part
Procedure Overview
This family describes procedures that completely close off part of the airway, most often to stop air or secretions from passing through a specific bronchus or to control a leak. A common application is placing an endobronchial valve to block airflow into a diseased or overinflated portion of the lung, a technique used in lung volume reduction for severe emphysema or to seal a persistent air leak after surgery or trauma. Occlusion may also be used to manage a bronchopleural fistula by blocking the affected airway segment, giving the surrounding lung tissue a chance to heal.
Anatomy & Axis Detail
Main Bronchus, Right
The right main bronchus, shorter and more vertically angled than its left counterpart, is occluded to completely block airflow through it, commonly to manage a persistent bronchopleural fistula, uncontrolled air leak after lung surgery, or massive hemoptysis when the bleeding source cannot be otherwise controlled. This is typically achieved bronchoscopically with an endobronchial blocker, valve, or sealant advanced through the airway and positioned at the origin of the right main bronchus. Because this bronchus supplies the entire right lung, occlusion here effectively excludes the whole lung from ventilation, so it is used selectively and often as a bridge to definitive surgical management, with the patient's tolerance of single-lung ventilation considered beforehand.
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.
Coding & Documentation
Coders select this family when the documentation describes a deliberate, complete blockage of an airway lumen, whether achieved with an implanted valve, coil, or other blocking material, or by suturing or clipping a bronchus shut. The device value and specific bronchial or tracheal body part must match the operative note precisely, since occlusion is frequently performed at a segmental or subsegmental level. A common error is coding a therapeutic valve placement as Insertion alone without recognizing that the intent to block airflow makes Occlusion the more accurate root operation, or missing that occlusion of a bronchus during lobectomy for stump closure is typically integral to the resection and not coded separately.