ICD-10-PCS Billable Code

04S60ZZ

Reposition Colic Artery, Right to No Qualifier with No Device, Open Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System4 Lower Arteries
OperationS Reposition
Body Part6 Colic Artery, Right
Approach0 Open
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Moving to its normal location, or other suitable location, all or a portion of a body part

Procedure Overview

Reposition procedures move an artery, or a segment of one, to a different location or restore it to its proper anatomic position without removing tissue or adding replacement material. In the lower extremities and pelvis this is an uncommon but important root operation, most often encountered when an artery has been displaced by trauma, congenital anomaly, or a prior surgical dissection and needs to be moved to a location where it functions correctly or does not interfere with another planned procedure.

Examples include transposing a renal or iliac artery during complex aortic reconstruction, or relocating a vessel during organ transplantation to create adequate inflow to a transplanted kidney. The vessel itself is not resected or replaced; it is detached at one end and reattached in a new position or orientation.

Anatomy & Axis Detail

Colic Artery, Right

The right colic artery, typically a branch of the superior mesenteric artery, supplies the ascending colon and hepatic flexure and can require surgical repositioning in the context of bowel reconstruction, vascular anomaly correction, or reimplantation during extensive right-sided colonic or mesenteric vascular surgery. Reposition moves the vessel or its origin to a new location while preserving the artery itself, which may be necessary to maintain adequate perfusion to the ascending colon when adjacent structures are resected or rearranged. Because the right colic artery's origin and branching pattern vary considerably between individuals, sometimes arising as a common trunk with the ileocolic artery, careful identification is essential before any repositioning to avoid compromising colonic blood supply. This procedure is uncommon in isolation and generally accompanies more extensive colonic vascular reconstruction.

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

Coders need operative documentation that clearly states the artery was moved to a new location, not simply exposed, clamped, or repaired in place, since Reposition requires an actual change in anatomic position. The note should specify the originating and destination location of the vessel, which affects the body part value selected.

A frequent mistake is coding a transposition performed as part of a larger transplant or bypass procedure as a separate Reposition when it is actually an integral, non-separately-reportable step of the main procedure. Coders also sometimes confuse temporary retraction or mobilization of a vessel during exposure, which is not coded at all, with true Reposition, which requires a permanent relocation.

Commonly Confused With

TransferTransfer, used elsewhere in ICD-10-PCS for moving tissue while keeping its vascular supply intact, is conceptually similar but does not apply to arteries functioning as the primary body part being moved for their own sake.
BypassBypass can resemble Reposition when a vessel's flow path is altered, but Bypass creates a new conduit or route rather than physically relocating the native artery, which is the defining feature of Reposition.