0BL57DZ
Occlusion Middle Lobe Bronchus, Right to No Qualifier with Intraluminal Device, Via Natural or Artificial Opening Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | B Respiratory System |
| Operation | L Occlusion |
| Body Part | 5 Middle Lobe Bronchus, Right |
| Approach | 7 Via Natural or Artificial Opening |
| Device | D Intraluminal 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
Middle Lobe Bronchus, Right
The middle lobe bronchus supplies the smallest lobe of the right lung and is occluded far less frequently than other bronchial segments, generally to control an air leak, fistula, or localized bleeding confined to the right middle lobe when preserving the rest of the lung is desired. Its short length and origin close to both the upper and lower lobe bronchi make selective occlusion technically challenging, since a device positioned too proximally or distally risks affecting adjacent lobes. Bronchoscopic placement of an endobronchial valve or blocker is typically guided by direct visualization and fluoroscopy to confirm the device sits precisely within the middle lobe bronchus before airflow to that lobe is fully blocked.
Approach: Via Natural or Artificial Opening
Via Natural or Artificial Opening means the instrument reaches the target site by passing through an existing body orifice, such as the mouth or urethra, or a surgically created opening like a stoma, without additional incision or scope guidance. It is distinguished from the Endoscopic variant by the absence of a visualizing scope, and from External by actually traversing into the body through that opening.
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.
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.