ICD-10-PCS Billable Code

04LN0DZ

Occlusion Popliteal Artery, Left to No Qualifier with Intraluminal Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System4 Lower Arteries
OperationL Occlusion
Body PartN Popliteal Artery, Left
Approach0 Open
DeviceD Intraluminal Device
QualifierZ No Qualifier

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

Popliteal Artery, Left

The popliteal artery behind the left knee is anatomically confined within the popliteal fossa and subject to repetitive flexion stress, which predisposes it to aneurysm formation and adventitial cystic disease, both common reasons for planned occlusion as part of aneurysm exclusion before or alongside a femoral-to-tibial bypass. Trauma from knee dislocation or fracture can also necessitate urgent occlusion of a damaged segment to control hemorrhage while a reconstructive plan is arranged. Because the vessel sits just proximal to its trifurcation into the anterior tibial, posterior tibial, and peroneal arteries, the level at which occlusion occurs strongly influences how much collateral runoff remains to the foot, so procedural notes should specify the segment involved relative to this branch point.

Approach: Open

Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.

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 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.

Commonly Confused With

RestrictionRestriction is the procedure most easily confused with Occlusion, since both narrow a vessel, but Restriction only partially reduces the diameter or flow while Occlusion eliminates it completely - the operative note's description of the intended endpoint is the deciding factor.
DestructionDestruction is another neighboring concept when tissue rather than a vessel lumen is being eliminated, and coders should check whether the artery itself was closed versus abnormal tissue fed by it being obliterated.