ICD-10-PCS Billable Code

04Q80ZZ

Repair Colic Artery, Middle to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System4 Lower Arteries
OperationQ Repair
Body Part8 Colic Artery, Middle
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Restoring, to the extent possible, a body part to its normal anatomic structure and function

Procedure Overview

Repair procedures on the lower arteries address a structural problem, such as a laceration, perforation, or traumatic injury, by restoring the vessel to its normal architecture using the surgeon's own techniques rather than a graft or prosthetic patch. This is the default root operation coders reach for when no other, more specific root operation like Bypass, Replacement, or Supplement accurately describes what was done to fix the vessel.

Common clinical scenarios include suturing an iatrogenic arterial injury sustained during catheterization, closing a puncture site that will not stop bleeding with simple pressure, or repairing a vessel nicked during an unrelated abdominal or orthopedic operation. Because Repair is the root operation reserved for when nothing else fits, it tends to show up in trauma and complication scenarios rather than in planned, elective vascular work.

Anatomy & Axis Detail

Colic Artery, Middle

The middle colic artery, generally a branch of the superior mesenteric artery, travels within the transverse mesocolon to supply the transverse colon, an area where anatomic variation is common and the vessel may bifurcate early or share territory with adjacent colic branches. Repair is indicated for iatrogenic laceration during transverse colon resection, gastric or pancreatic surgery involving the transverse mesocolon, or traumatic injury, restoring wall integrity to maintain perfusion to this central colonic segment. Its course close to the pancreas and the root of the transverse mesocolon means repair often occurs in a crowded surgical field shared with pancreatic and gastroepiploic structures. Because the middle colic artery is a key contributor to the marginal artery of the colon, careful repair supports collateral flow to neighboring bowel segments during complex abdominal procedures.

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.

Coding & Documentation

Documentation needs to describe the defect being fixed, the artery involved, and confirm that the surgeon used direct suture or similar technique without introducing graft material, since adding a patch or graft shifts the case to Supplement or Replacement instead. The operative note should also make clear whether the repair was the primary intervention or an incidental step during a larger procedure, since incidental repairs during an unrelated primary procedure are sometimes not separately reportable.

A frequent coding mistake is defaulting to Repair when a more specific root operation actually applies, since Repair is technically the "not elsewhere classified" option and coders should first rule out Bypass, Occlusion, Restriction, or Supplement before settling on it.

Commonly Confused With

SupplementSupplement is the closest neighbor and the distinction hinges on whether material was added to reinforce the vessel wall; if a patch angioplasty or graft material was used to close the defect, Supplement is correct, while a simple suture repair without added material is Repair.
BypassBypass procedures are sometimes confused with Repair when a damaged segment is rerouted around rather than directly fixed; Bypass always involves creating a new route from one point to another, which Repair does not.