ICD-10-PCS Billable Code

04SL0ZZ

Reposition 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
OperationS Reposition
Body PartL Femoral Artery, Left
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

Femoral Artery, Left

The left femoral artery serves as the primary conduit of blood to the lower limb below the inguinal ligament and, like its right counterpart, may require repositioning when disease or prior intervention has compromised its normal course. Reposition procedures on this vessel include transposing a patent segment, such as moving the profunda femoris origin, to restore adequate distal perfusion without introducing a graft, or relocating the artery during reconstructive groin surgery after trauma or infection. The vessel's superficial location in the femoral triangle makes it readily accessible for these maneuvers but also exposes it to injury during unrelated procedures. Operative documentation should describe the specific segment moved and its new attachment site to distinguish repositioning from bypass grafting or endarterectomy performed nearby.

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.