ICD-10-PCS Billable Code

0BL43DZ

Occlusion Upper Lobe Bronchus, Right to No Qualifier with Intraluminal Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemB Respiratory System
OperationL Occlusion
Body Part4 Upper Lobe Bronchus, Right
Approach3 Percutaneous
DeviceD Intraluminal Device
QualifierZ 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

Upper Lobe Bronchus, Right

The upper lobe bronchus on the right side supplies the apical, posterior, and anterior segments of the right upper lobe, and its occlusion is performed to isolate that lobe specifically, most often using an endobronchial valve for a persistent air leak following upper lobectomy or pleurodesis failure, or to control a localized fistula or hemorrhage confined to the upper lobe. Because this bronchus branches off close to the right main bronchus, precise bronchoscopic positioning is needed to occlude only the intended lobar branch without inadvertently blocking the main bronchus or adjacent middle and lower lobe branches. Confirming correct placement with fluoroscopy or direct visualization is important given the short segment available for device seating.

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.

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.

Commonly Confused With

RestrictionOcclusion is often confused with Restriction, which narrows rather than completely closes a lumen; a partially constricting band would be Restriction, while a valve or ligature that stops all airflow is Occlusion.
ExcisionIt also differs from Excision, since occlusion leaves the airway segment in place but nonfunctional rather than removing tissue.