ICD-10-PCS Billable Code

06UM4JZ

Supplement Femoral Vein, Right to No Qualifier with Synthetic Substitute, Percutaneous Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System6 Lower Veins
OperationU Supplement
Body PartM Femoral Vein, Right
Approach4 Percutaneous Endoscopic
DeviceJ Synthetic Substitute
QualifierZ No Qualifier

Operation Definition

Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a body part

Procedure Overview

This family covers procedures where material - either biological tissue or a synthetic substance - is added to a lower-body vein to reinforce its wall or bolster a function that has become impaired, without removing the vein itself. The native vessel stays in place; the added material works alongside it, much like patching or wrapping a weakened structure to give it more support.

This approach is used when a vein wall has become thin, weakened, or dilated in a way that threatens its integrity, or when a venous valve or structure needs added support to improve its performance without a full replacement. Examples include reinforcing a vein wall with a patch during repair of an aneurysmal or injured segment, or augmenting a valve-bearing area of the vein to help reduce reflux in chronic venous insufficiency.

Supplement procedures are generally less invasive in concept than full replacement, since the body's own vein continues to do the primary work while the added material provides extra structural support.

Anatomy & Axis Detail

Femoral Vein, Right

The right femoral vein is a large-caliber vessel running alongside the femoral artery in the proximal thigh, continuing from the popliteal vein and receiving the great saphenous vein before ascending to become the external iliac vein, and it is among the most frequently accessed veins for central lines and endovascular procedures. Supplement reinforces a wall weakened by repeated cannulation, aneurysmal change, or focal thinning identified during vascular repair or graft harvesting. Because this vessel sustains high flow and is a common access site, reinforcing material must preserve a smooth, patent lumen to reduce the risk of thrombosis or stenosis at the treated segment. Patch or graft material is placed over the compromised wall, and documentation should confirm laterality, the material used, and that the native femoral vein was preserved rather than excised.

Approach: Percutaneous Endoscopic

Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.

Device: Synthetic Substitute

Synthetic Substitute designates a device made from manufactured, non-biologic material, such as mesh or prosthetic components, used to replace or augment a body part. It is distinguished from the two tissue substitute categories by its artificial composition, which carries different considerations for integration and long-term durability than biologic grafts.

Coding & Documentation

Coding from this family depends on documentation showing that material was placed onto or into an existing vein to reinforce it, with the native vessel remaining largely intact rather than excised. The note should identify the specific vein and the reinforcing material, such as a patch, cuff, or mesh, and whether it is autologous or nonautologous.

The most frequent mistake is defaulting to Repair when a patch graft was actually used, since both can appear in operative language about "patching" a vein. If a patch or graft material is used specifically to reinforce the wall, Supplement is the correct root operation; plain Repair applies only when the vein is sutured or closed without added reinforcing material. The reverse error also occurs - coding Replacement when only part of the vein wall was augmented rather than an entire segment being taken out and substituted.

Commonly Confused With

RepairRepair is the closest and most commonly confused family, since both can involve closing or reinforcing a damaged vein; the dividing line is whether reinforcing material was actually implanted (Supplement) or the vein was simply sutured back together with no added material (Repair).
ReplacementReplacement is distinguished by the removal of the native vein segment, which does not occur in Supplement.
RestrictionRestriction procedures, which narrow a vein's lumen rather than reinforce its wall, address a different clinical goal entirely.