ICD-10-PCS Billable Code

04QL0ZZ

Repair Femoral Artery, Left 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 PartL Femoral Artery, Left
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

Femoral Artery, Left

The left femoral artery extends from the external iliac artery into the thigh, supplying the leg and serving as a major site for both surgical exposure and percutaneous vascular access, which makes it susceptible to iatrogenic pseudoaneurysm and arteriovenous fistula formation. Repair restores the vessel's own wall and continuity following such injury, traumatic laceration, or localized dissection, without introducing graft material or rerouting flow. Positioned within the femoral triangle near the femoral vein and nerve, this artery is readily exposed through a groin incision, and its bifurcation into superficial and deep femoral branches just distal to this point means documentation should specify that the repair involves the common femoral segment rather than one of its named branches to ensure precise coding.

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.