your map of the icd-9 to icd-10 pcs conversion …...relationships between the codes in the icd-9-cm...
TRANSCRIPT
Your Map of the ICD-9 to ICD-10 PCS Conversion
Disclaimer 3
Endoscopy 4
Interventional Cardiology 11
Neuromodulation 14
Peripheral Interventions 15
Rhythm Management and Electrophysiology 55
Urology 62
Pelvic Health 65
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Table of Contents
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Accordingly for mesh for stress urinary incontinence: CAUTION: Federal Law (USA) restricts this device to sale by or on the order of a physician trained in use of mesh for the repair of stress urinary incontinence.
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This document is not a reflection of the Center for Medicare and Medicaid Services (CMS) official General Equivalence Mapping (GEM) for ICD-9-CM procedure classification to ICD-10-PCS. There is not a simple “crosswalk from I-9- to PCS” in the GEM files. The GEM file is an official CMS reference mapping that attempts to include all valid relationships between the codes in the ICD-9-CM procedure classification and the ICD-10 Procedure Code System (ICD-10-PCS). Although helpful for review, the GEM translation should not replace coding from the official medical record and assigning the appropriate ICD-10 code based on the individual case record. The translations provided in this document were derived from coding directly using ICD-10-PCS coding resources making use of the increased specificity in PCS. Therefore, the translations provided are not an exact match to the CMS GEM files and are not based on any official CMS resource. The most accurate coding for ICD-10-PCS should be based on access to the individual medical record to see the specific nature of the procedure and assign the correct PCS code(s) to the record.
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Disclaimers
See page 3 for important information about the uses and limitations of this document. CORP-224204-AB SEPT2015
Endoscopy
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
51.10Endoscopic retrograde cholangiopancreatography [ERCP]
BF110ZZ Fluoroscopy of Biliary and Pancreatic Ducts using High Osmolar Contrast
BF111ZZ Fluoroscopy of Biliary and Pancreatic Ducts using Low Osmolar Contrast
BF11YZZ Fluoroscopy of Biliary and Pancreatic Ducts using Other Contrast
0FJB8ZZ Inspection of Hepatobiliary Duct, Via Natural or Artificial Opening Endoscopic
0FJD8ZZ Inspection of Pancreatic Duct, Via Natural or Artificial Opening Endoscopic
51.11Endoscopic retrograde cholangiography (ERC)
BF100ZZ Fluoroscopy of Bile Ducts using High Osmolar Contrast
BF101ZZ Fluoroscopy of Bile Ducts using Low Osmolar Contrast
BF10YZZ Fluoroscopy of Bile Ducts using Other Contrast
BF000ZZ Plain Radiography of Bile Ducts using High Osmolar Contrast
BF001ZZ Plain Radiography of Bile Ducts using Low Osmolar Contrast
BF00YZZ Plain Radiography of Bile Ducts using Other Contrast
51.14Other closed (endoscopic) biopsy of biliary duct or sphincter of Oddi
0F954ZX Drainage of Right Hepatic Duct, Percutaneous Endoscopic Approach, Diagnostic
0F957ZX Drainage of Right Hepatic Duct, Via Natural or Artificial Opening, Diagnostic
0F958ZX Drainage of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0F964ZX Drainage of Left Hepatic Duct, Percutaneous Endoscopic Approach, Diagnostic
0F967ZX Drainage of Left Hepatic Duct, Via Natural or Artificial Opening, Diagnostic
0F968ZX Drainage of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0F984ZX Drainage of Cystic Duct, Percutaneous Endoscopic Approach, Diagnostic
0F987ZX Drainage of Cystic Duct, Via Natural or Artificial Opening, Diagnostic
0F988ZX Drainage of Cystic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0F994ZX Drainage of Common Bile Duct, Percutaneous Endoscopic Approach, Diagnostic
0F997ZX Drainage of Common Bile Duct, Via Natural or Artificial Opening, Diagnostic
0F998ZX Drainage of Common Bile Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0F9C4ZX Drainage of Ampulla of Vater, Percutaneous Endoscopic Approach, Diagnostic
0F9C7ZX Drainage of Ampulla of Vater, Via Natural or Artificial Opening, Diagnostic
0F9C8ZX Drainage of Ampulla of Vater, Via Natural or Artificial Opening Endoscopic, Diagnostic
0FB44ZX Excision of Gallbladder, Percutaneous Endoscopic Approach, Diagnostic
0FB54ZX Excision of Right Hepatic Duct, Percutaneous Endoscopic Approach, Diagnostic
0FB57ZX Excision of Right Hepatic Duct, Via Natural or Artificial Opening, Diagnostic
0FB58ZX Excision of Right Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0FB64ZX Excision of Left Hepatic Duct, Percutaneous Endoscopic Approach, Diagnostic
0FB67ZX Excision of Left Hepatic Duct, Via Natural or Artificial Opening, Diagnostic
0FB68ZX Excision of Left Hepatic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0FB84ZX Excision of Cystic Duct, Percutaneous Endoscopic Approach, Diagnostic
0FB87ZX Excision of Cystic Duct, Via Natural or Artificial Opening, Diagnostic
0FB88ZX Excision of Cystic Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0FB94ZX Excision of Common Bile Duct, Percutaneous Endoscopic Approach, Diagnostic
0FB97ZX Excision of Common Bile Duct, Via Natural or Artificial Opening, Diagnostic
0FB98ZX Excision of Common Bile Duct, Via Natural or Artificial Opening Endoscopic, Diagnostic
0FBC4ZX Excision of Ampulla of Vater, Percutaneous Endoscopic Approach, Diagnostic
0FBC7ZX Excision of Ampulla of Vater, Via Natural or Artificial Opening, Diagnostic
0FBC8ZX Excision of Ampulla of Vater, Via Natural or Artificial Opening Endoscopic, Diagnostic
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Endoscopy
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 5
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
51.98Other percutaneous procedures on biliary tract
0F753DZ Dilation of Right Hepatic Duct with Intraluminal Device, Percutaneous Approach
0F753ZZ Dilation of Right Hepatic Duct, Percutaneous Approach
0F763DZ Dilation of Left Hepatic Duct with Intraluminal Device, Percutaneous Approach
0F763ZZ Dilation of Left Hepatic Duct, Percutaneous Approach
0F783DZ Dilation of Cystic Duct with Intraluminal Device, Percutaneous Approach
0F783ZZ Dilation of Cystic Duct, Percutaneous Approach
0F793DZ Dilation of Common Bile Duct with Intraluminal Device, Percutaneous Approach
0F793ZZ Dilation of Common Bile Duct, Percutaneous Approach
0F754ZZ Dilation of Right Hepatic Duct, Percutaneous Endoscopic Approach
0F764ZZ Dilation of Left Hepatic Duct, Percutaneous Endoscopic Approach
0F784ZZ Dilation of Cystic Duct, Percutaneous Endoscopic Approach
0F794ZZ Dilation of Common Bile Duct, Percutaneous Endoscopic Approach
0FJB3ZZ Inspection of Hepatobiliary Duct, Percutaneous Approach
0FJB4ZZ Inspection of Hepatobiliary Duct, Percutaneous Endoscopic Approach
0F993ZZ Drainage of Common Bile Duct, Percutaneous Approach
0F994ZZ Drainage of Common Bile Duct, Percutaneous Endoscopic Approach
0FC53ZZ Extirpation of Matter from Right Hepatic Duct, Percutaneous Approach
0FC54ZZ Extirpation of Matter from Right Hepatic Duct, Percutaneous Endoscopic Approach
0FC63ZZ Extirpation of Matter from Left Hepatic Duct, Percutaneous Approach
0FC64ZZ Extirpation of Matter from Left Hepatic Duct, Percutaneous Endoscopic Approach
0FC83ZZ Extirpation of Matter from Cystic Duct, Percutaneous Approach
0FC84ZZ Extirpation of Matter from Cystic Duct, Percutaneous Endoscopic Approach
Endoscopy
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
32.27Bronchoscopic bronchial thermoplasty, ablation of airway smooth muscle
0B538ZZ Destruction of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic
0B548ZZ Destruction of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B568ZZ Destruction of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B578ZZ Destruction of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic
0B588ZZ Destruction of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B598ZZ Destruction of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic
0B5B8ZZ Destruction of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
32.01Endoscopic excision or destruction of lesion or tissue of bronchus
0B534ZZ Destruction of Right Main Bronchus, Percutaneous Endoscopic Approach
0B538ZZ Destruction of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic
0B544ZZ Destruction of Right Upper Lobe Bronchus, Percutaneous Endoscopic Approach
0B548ZZ Destruction of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B554ZZ Destruction of Right Middle Lobe Bronchus, Percutaneous Endoscopic Approach
0B558ZZ Destruction of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B564ZZ Destruction of Right Lower Lobe Bronchus, Percutaneous Endoscopic Approach
0B568ZZ Destruction of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B574ZZ Destruction of Left Main Bronchus, Percutaneous Endoscopic Approach
0B578ZZ Destruction of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic
0B584ZZ Destruction of Left Upper Lobe Bronchus, Percutaneous Endoscopic Approach
0B588ZZ Destruction of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0B594ZZ Destruction of Lingula Bronchus, Percutaneous Endoscopic Approach
0B598ZZ Destruction of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic
0B5B4ZZ Destruction of Left Lower Lobe Bronchus, Percutaneous Endoscopic Approach
0B5B8ZZ Destruction of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0BB34ZZ Excision of Right Main Bronchus, Percutaneous Endoscopic Approach
0BB38ZZ Excision of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic
0BB44ZZ Excision of Right Upper Lobe Bronchus, Percutaneous Endoscopic Approach
0BB48ZZ Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0BB54ZZ Excision of Right Middle Lobe Bronchus, Percutaneous Endoscopic Approach
0BB58ZZ Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0BB64ZZ Excision of Right Lower Lobe Bronchus, Percutaneous Endoscopic Approach
0BB68ZZ Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0BB74ZZ Excision of Left Main Bronchus, Percutaneous Endoscopic Approach
0BB78ZZ Excision of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic
0BB84ZZ Excision of Left Upper Lobe Bronchus, Percutaneous Endoscopic Approach
0BB88ZZ Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
0BB94ZZ Excision of Lingula Bronchus, Percutaneous Endoscopic Approach
0BB98ZZ Excision of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic
0BBB4ZZ Excision of Left Lower Lobe Bronchus, Percutaneous Endoscopic Approach
0BBB8ZZ Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic
Endoscopy
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
33.23 Other bronchoscopy
0BJ08ZZ Inspection of Tracheobronchial Tree, Via Natural or Artificial Opening Endoscopic
0BJK8ZZ Inspection of Right Lung, Via Natural or Artificial Opening Endoscopic
0BJL8ZZ Inspection of Left Lung, Via Natural or Artificial Opening Endoscopic
33.24Closed [endoscopic] biopsy of bronchus
0B933ZX Drainage of Right Main Bronchus, Percutaneous Approach, Diagnostic
0B934ZX Drainage of Right Main Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B937ZX Drainage of Right Main Bronchus, Via Natural or Artificial Opening, Diagnostic
0B938ZX Drainage of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B943ZX Drainage of Right Upper Lobe Bronchus, Percutaneous Approach, Diagnostic
0B944ZX Drainage of Right Upper Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B947ZX Drainage of Right Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0B948ZX Drainage of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B953ZX Drainage of Right Middle Lobe Bronchus, Percutaneous Approach, Diagnostic
0B954ZX Drainage of Right Middle Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B957ZX Drainage of Right Middle Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0B958ZX Drainage of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B963ZX Drainage of Right Lower Lobe Bronchus, Percutaneous Approach, Diagnostic
0B964ZX Drainage of Right Lower Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B967ZX Drainage of Right Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0B968ZX Drainage of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B973ZX Drainage of Left Main Bronchus, Percutaneous Approach, Diagnostic
0B974ZX Drainage of Left Main Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B977ZX Drainage of Left Main Bronchus, Via Natural or Artificial Opening, Diagnostic
0B978ZX Drainage of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B983ZX Drainage of Left Upper Lobe Bronchus, Percutaneous Approach, Diagnostic
0B984ZX Drainage of Left Upper Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B987ZX Drainage of Left Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0B988ZX Drainage of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B993ZX Drainage of Lingula Bronchus, Percutaneous Approach, Diagnostic
0B994ZX Drainage of Lingula Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B997ZX Drainage of Lingula Bronchus, Via Natural or Artificial Opening, Diagnostic
0B998ZX Drainage of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9B3ZX Drainage of Left Lower Lobe Bronchus, Percutaneous Approach, Diagnostic
0B9B4ZX Drainage of Left Lower Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0B9B7ZX Drainage of Left Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0B9B8ZX Drainage of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB33ZX Excision of Right Main Bronchus, Percutaneous Approach, Diagnostic
0BB34ZX Excision of Right Main Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB37ZX Excision of Right Main Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB38ZX Excision of Right Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB43ZX Excision of Right Upper Lobe Bronchus, Percutaneous Approach, Diagnostic
0BB44ZX Excision of Right Upper Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB47ZX Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB48ZX Excision of Right Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB53ZX Excision of Right Middle Lobe Bronchus, Percutaneous Approach, Diagnostic
Endoscopy
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
33.24Closed [endoscopic] biopsy of bronchus (Continued)
0BB54ZX Excision of Right Middle Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB57ZX Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB58ZX Excision of Right Middle Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB63ZX Excision of Right Lower Lobe Bronchus, Percutaneous Approach, Diagnostic
0BB64ZX Excision of Right Lower Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB67ZX Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB68ZX Excision of Right Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB73ZX Excision of Left Main Bronchus, Percutaneous Approach, Diagnostic
0BB74ZX Excision of Left Main Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB77ZX Excision of Left Main Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB78ZX Excision of Left Main Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB83ZX Excision of Left Upper Lobe Bronchus, Percutaneous Approach, Diagnostic
0BB84ZX Excision of Left Upper Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB87ZX Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB88ZX Excision of Left Upper Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BB93ZX Excision of Lingula Bronchus, Percutaneous Approach, Diagnostic
0BB94ZX Excision of Lingula Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BB97ZX Excision of Lingula Bronchus, Via Natural or Artificial Opening, Diagnostic
0BB98ZX Excision of Lingula Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBB3ZX Excision of Left Lower Lobe Bronchus, Percutaneous Approach, Diagnostic
0BBB4ZX Excision of Left Lower Lobe Bronchus, Percutaneous Endoscopic Approach, Diagnostic
0BBB7ZX Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening, Diagnostic
0BBB8ZX Excision of Left Lower Lobe Bronchus, Via Natural or Artificial Opening Endoscopic, Diagnostic
33.27Closed endoscopic biopsy of lung
0B9K8ZX Drainage of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9L8ZX Drainage of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0B9M8ZX Drainage of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBK7ZX Excision of Right Lung, Via Natural or Artificial Opening, Diagnostic
0BBK8ZX Excision of Right Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBL7ZX Excision of Left Lung, Via Natural or Artificial Opening, Diagnostic
0BBL8ZX Excision of Left Lung, Via Natural or Artificial Opening Endoscopic, Diagnostic
0BBM4ZX Excision of Bilateral Lungs, Percutaneous Endoscopic Approach, Diagnostic
0BBM7ZX Excision of Bilateral Lungs, Via Natural or Artificial Opening, Diagnostic
0BBM8ZX Excision of Bilateral Lungs, Via Natural or Artificial Opening Endoscopic, Diagnostic
31.93Replacement of laryngeal or tracheal stent
0C7S0DZ Dilation of Larynx with Intraluminal Device, Open Approach
0C7S3DZ Dilation of Larynx with Intraluminal Device, Percutaneous Approach
0C7S4DZ Dilation of Larynx with Intraluminal Device, Percutaneous Endoscopic Approach
0C7S7DZ Dilation of Larynx with Intraluminal Device, Via Natural or Artificial Opening
0C7S8DZ Dilation of Larynx with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0CPS0DZ Removal of Intraluminal Device from Larynx, Open Approach
0CPS3DZ Removal of Intraluminal Device from Larynx, Percutaneous Approach
0CPS7DZ Removal of Intraluminal Device from Larynx, Via Natural or Artificial Opening
0CPS8DZ Removal of Intraluminal Device from Larynx, Via Natural or Artificial Opening Endoscopic
Endoscopy
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
31.99 Other operations on trachea
0B710DZ Dilation of Trachea with Intraluminal Device, Open Approach
0B710ZZ Dilation of Trachea, Open Approach
0B713DZ Dilation of Trachea with Intraluminal Device, Percutaneous Approach
0B713ZZ Dilation of Trachea, Percutaneous Approach
0B714DZ Dilation of Trachea with Intraluminal Device, Percutaneous Endoscopic Approach
0B714ZZ Dilation of Trachea, Percutaneous Endoscopic Approach
0B717DZ Dilation of Trachea with Intraluminal Device, Via Natural or Artificial Opening
0B717ZZ Dilation of Trachea, Via Natural or Artificial Opening
0B718DZ Dilation of Trachea with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0B718ZZ Dilation of Trachea, Via Natural or Artificial Opening Endoscopic
0B720DZ Dilation of Carina with Intraluminal Device, Open Approach
0B720ZZ Dilation of Carina, Open Approach
0B723DZ Dilation of Carina with Intraluminal Device, Percutaneous Approach
0B723ZZ Dilation of Carina, Percutaneous Approach
0B724DZ Dilation of Carina with Intraluminal Device, Percutaneous Endoscopic Approach
0B724ZZ Dilation of Carina, Percutaneous Endoscopic Approach
0B727DZ Dilation of Carina with Intraluminal Device, Via Natural or Artificial Opening
0B727ZZ Dilation of Carina, Via Natural or Artificial Opening
0B728DZ Dilation of Carina with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0B728ZZ Dilation of Carina, Via Natural or Artificial Opening Endoscopic
98.15Removal of intraluminal foreign body from trachea and bronchus without incision
0BC17ZZ Extirpation of Matter from Trachea, Via Natural or Artificial Opening
0BC18ZZ Extirpation of Matter from Trachea, Via Natural or Artificial Opening Endoscopic
0BC37ZZ Extirpation of Matter from Right Main Bronchus, Via Natural or Artificial Opening
0BC38ZZ Extirpation of Matter from Right Main Bronchus, Via Natural or Artificial Opening Endoscopic
0BC77ZZ Extirpation of Matter from Left Main Bronchus, Via Natural or Artificial Opening
0BC78ZZ Extirpation of Matter from Left Main Bronchus, Via Natural or Artificial Opening Endoscopic
42.81Insertion of permanent tube into esophagus
0DH50DZ Insertion of Intraluminal Device into Esophagus, Open Approach
0DH50UZ Insertion of Feeding Device into Esophagus, Open Approach
0DH53DZ Insertion of Intraluminal Device into Esophagus, Percutaneous Approach
0DH53UZ Insertion of Feeding Device into Esophagus, Percutaneous Approach
0DH54DZ Insertion of Intraluminal Device into Esophagus, Percutaneous Endoscopic Approach
0DH54UZ Insertion of Feeding Device into Esophagus, Percutaneous Endoscopic Approach
0DH57DZ Insertion of Intraluminal Device into Esophagus, Via Natural or Artificial Opening
0DH57UZ Insertion of Feeding Device into Esophagus, Via Natural or Artificial Opening
0DH58DZ Insertion of Intraluminal Device into Esophagus, Via Natural or Artificial Opening Endoscopic
0DH58UZ Insertion of Feeding Device into Esophagus, Via Natural or Artificial Opening Endoscopic
Endoscopy
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
46.86Endoscopic insertion of colonic stent(s)
0D788DZ Dilation of Small Intestine with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D798DZ Dilation of Duodenum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D7A8DZ Dilation of Jejunum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D7B8DZ Dilation of Ileum with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D7E8DZ Dilation of Large Intestine with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0DH88DZ Insertion of Intraluminal Device into Small Intestine, Via Natural or Artificial Opening Endoscopic
0DH98DZ Insertion of Intraluminal Device into Duodenum, Via Natural or Artificial Opening Endoscopic
0DHA8DZ Insertion of Intraluminal Device into Jejunum, Via Natural or Artificial Opening Endoscopic
0DHB8DZ Insertion of Intraluminal Device into Ileum, Via Natural or Artificial Opening Endoscopic
0DHE8DZ Insertion of Intraluminal Device into Large Intestine, Via Natural or Artificial Opening Endoscopic
0DHP8DZ Insertion of Intraluminal Device into Rectum, Via Natural or Artificial Opening Endoscopic
0D7K8DZ Dilation of Ascending Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D7L8DZ Dilation of Transverse Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D7M8DZ Dilation of Descending Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0D7N8DZ Dilation of Sigmoid Colon with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
51.87Endoscopic insertion of stent (tube) into bile duct
0F758DZ Dilation of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F768DZ Dilation of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F788DZ Dilation of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F798DZ Dilation of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0FHB4DZ Insertion of Intraluminal Device into Hepatobiliary Duct, Percutaneous Endoscopic Approach
0FHB8DZ Insertion of Intraluminal Device into Hepatobiliary Duct, Via Natural or Artificial Opening Endoscopic
97.05Replacement of stent (tube) in biliary or pancreatic duct
0F757DZ Dilation of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening
0F758DZ Dilation of Right Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F767DZ Dilation of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening
0F768DZ Dilation of Left Hepatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F787DZ Dilation of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening
0F788DZ Dilation of Cystic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F797DZ Dilation of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening
0F798DZ Dilation of Common Bile Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0F7D7DZ Dilation of Pancreatic Duct with Intraluminal Device, Via Natural or Artificial Opening
0F7D8DZ Dilation of Pancreatic Duct with Intraluminal Device, Via Natural or Artificial Opening Endoscopic
0FHB7DZ Insertion of Intraluminal Device into Hepatobiliary Duct, Via Natural or Artificial Opening
0FHB8DZ Insertion of Intraluminal Device into Hepatobiliary Duct, Via Natural or Artificial Opening Endoscopic
0FPB7DZ Removal of Intraluminal Device from Hepatobiliary Duct, Via Natural or Artificial Opening
0FPB8DZ Removal of Intraluminal Device from Hepatobiliary Duct, Via Natural or Artificial Opening Endoscopic
0FPBXDZ Removal of Intraluminal Device from Hepatobiliary Duct, External Approach
0FPD7DZ Removal of Intraluminal Device from Pancreatic Duct, Via Natural or Artificial Opening
0FPD8DZ Removal of Intraluminal Device from Pancreatic Duct, Via Natural or Artificial Opening Endoscopic
0FPDXDZ Removal of Intraluminal Device from Pancreatic Duct, External Approach
52.99 Other pancreatic proceduresOF9G4ZZ Drainage of Pancreas, Percutaneous Endoscopic Approach
OF9G40Z Drainage of Pancreas with Drainage Device, Percutaneous Endoscopic Approach
Interventional Cardiology
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
37.21Right heart cardiac catheterization
4A023N6 Measurement of Cardiac Sampling and Pressure, Right Heart, Percutaneous Approach
37.22Left heart cardiac catheterization
4A023N7 Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach
37.23
Combined right and left heart cardiac catheterization
4A023N8 Measurement of Cardiac Sampling and Pressure, Bilateral, Percutaneous Approach
17.55Transluminal coronary atherectomy
02C03ZZ Extirpation of Matter from Coronary Artery, One Site, Percutaneous Approach
02C13ZZ Extirpation of Matter from Coronary Artery, Two Sites, Percutaneous Approach
02C23ZZ Extirpation of Matter from Coronary Artery, Three Sites, Percutaneous Approach
02C33ZZ Extirpation of Matter from Coronary Artery, Four or More Sites, Percutaneous Approach
36.06
Insertion of non-drug-eluting coronary artery stent(s)
02703DZ Dilation of Coronary Artery, One Site with Intraluminal Device, Percutaneous Approach
02703D6 Dilation of Coronary Artery, One Site, Bifurcation, with Intraluminal Device, Percutaneous Approach
02713D6 Dilation of Coronary Artery, Two Sites, Bifurcation, with Intraluminal Device, Percutaneous Approach
02713DZ Dilation of Coronary Artery, Two Sites with Intraluminal Device, Percutaneous Approach
02723D6 Dilation of Coronary Artery, Three Sites, Bifurcation, with Intraluminal Device, Percutaneous Approach
02723DZ Dilation of Coronary Artery, Three Sites with Intraluminal Device, Percutaneous Approach
02733D6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Intraluminal Device, Percutaneous Approach
02733DZ Dilation of Coronary Artery, Four or More Sites with Intraluminal Device, Percutaneous Approach
027034Z Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, Percutaneous Approach
36.07Insertion of drug-eluting coronary artery stent(s)
0270346 Dilation of Coronary Artery, One Site, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Approach
027034Z Dilation of Coronary Artery, One Site with Drug-eluting Intraluminal Device, Percutaneous Approach
0271346 Dilation of Coronary Artery, Two Sites, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Approach
027134Z Dilation of Coronary Artery, Two Sites with Drug-eluting Intraluminal Device, Percutaneous Approach
0272346Dilation of Coronary Artery, Three Sites, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Approach
027234Z Dilation of Coronary Artery, Three Sites with Drug-eluting Intraluminal Device, Percutaneous Approach
0273346Dilation of Coronary Artery, Four or More Sites, Bifurcation, with Drug-eluting Intraluminal Device, Percutaneous Approach
027334Z Dilation of Coronary Artery, Four or More Sites with Drug-eluting Intraluminal Device, Percutaneous Approach
35.05Endovascular replacement of aortic valve
02RF37Z Replacement of Aortic Valve with Autologous Tissue Substitute, Percutaneous Approach
02RF38Z Replacement of Aortic Valve with Zooplastic Tissue, Percutaneous Approach
02RF3JZ Replacement of Aortic Valve with Synthetic Substitute, Percutaneous Approach
02RF3KZ Replacement of Aortic Valve with Nonautologous Tissue Substitute, Percutaneous Approach
35.06Transapical replacement of aortic valve
02RF37H Replacement of Aortic Valve with Autologous Tissue Substitute, Transapical, Percutaneous Approach
02RF38H Replacement of Aortic Valve with Zooplastic Tissue, Transapical, Percutaneous Approach
02RF3JH Replacement of Aortic Valve with Synthetic Substitute, Transapical, Percutaneous Approach
02RF3KH Replacement of Aortic Valve with Nonautologous Tissue Substitute, Transapical, Percutaneous Approach
35.07Endovascular replacement of pulmonary valve
02RH37Z Replacement of Pulmonary Valve with Autologous Tissue Substitute, Percutaneous Approach
02RH38Z Replacement of Pulmonary Valve with Zooplastic Tissue, Percutaneous Approach
02RH3JZ Replacement of Pulmonary Valve with Synthetic Substitute, Percutaneous Approach
02RH3KZ Replacement of Pulmonary Valve with Nonautologous Tissue Substitute, Percutaneous Approach
35.08Transapical replacement of pulmonary valve
02RH37H Replacement of Pulmonary Valve with Autologous Tissue Substitute, Transapical, Percutaneous Approach
02RH38H Replacement of Pulmonary Valve with Zooplastic Tissue, Transapical, Percutaneous Approach
02RH3JH Replacement of Pulmonary Valve with Synthetic Substitute, Transapical, Percutaneous Approach
02RH3KH Replacement of Pulmonary Valve with Nonautologous Tissue Substitute, Transapical, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 11
Interventional Cardiology
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
35.96Percutaneous balloon valvuloplasty
027F3ZZ Dilation of Aortic Valve, Percutaneous Approach
027F4ZZ Dilation of Aortic Valve, Percutaneous Endoscopic Approach
027G3ZZ Dilation of Mitral Valve, Percutaneous Approach
027G4ZZ Dilation of Mitral Valve, Percutaneous Endoscopic Approach
027H3ZZ Dilation of Pulmonary Valve, Percutaneous Approach
027H4ZZ Dilation of Pulmonary Valve, Percutaneous Endoscopic Approach
027J3ZZ Dilation of Tricuspid Valve, Percutaneous Approach
027J4ZZ Dilation of Tricuspid Valve, Percutaneous Endoscopic Approach
35.97
Percutaneous mitral valve repair with implant
02UG3JZ Supplement Mitral Valve with Synthetic Substitute, Percutaneous Approach
00.59
Intravascular pressure measurement of coronary arteries
4A033BC Measurement of Arterial Pressure, Coronary, Percutaneous Approach
00.66
Percutaneous transluminal coronary angioplasty [PTCA]
02703ZZ Dilation of Coronary Artery, One Site, Percutaneous Approach
02704ZZ Dilation of Coronary Artery, One Site, Percutaneous Endoscopic Approach
02713ZZ Dilation of Coronary Artery, Two Sites, Percutaneous Approach
02714ZZ Dilation of Coronary Artery, Two Sites, Percutaneous Endoscopic Approach
02723ZZ Dilation of Coronary Artery, Three Sites, Percutaneous Approach
02724ZZ Dilation of Coronary Artery, Three Sites, Percutaneous Endoscopic Approach
02733ZZ Dilation of Coronary Artery, Four or More Sites, Percutaneous Approach
02734ZZ Dilation of Coronary Artery, Four or More Sites, Percutaneous Endoscopic Approach
02703Z6 Dilation of Coronary Artery, One Site, Bifurcation, Percutaneous Approach
02713Z6 Dilation of Coronary Artery, Two Sites, Bifurcation, Percutaneous Approach
02723Z6 Dilation of Coronary Artery, Three Sites, Bifurcation, Percutaneous Approach
02733Z6 Dilation of Coronary Artery, Four or More Sites, Bifurcation, Percutaneous Approach
39.61
Extracorporeal circulation auxiliary to open heart surgery
5A1221Z Performance of Cardiac Output, Continuous
00.24Intravascular imaging of coronary vessels
B240ZZ3 Ultrasonography of Single Coronary Artery, Intravascular
B241ZZ3 Ultrasonography of Multiple Coronary Arteries, Intravascular
B244ZZ3 Ultrasonography of Right Heart, Intravascular
B245ZZ3 Ultrasonography of Left Heart, Intravascular
B246ZZ3 Ultrasonography of Right and Left Heart, Intravascular
B24DZZ3 Ultrasonography of Pediatric Heart, Intravascular
B244ZZ3 Ultrasonography of Right Heart, Intravascular
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 12
Interventional Cardiology
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
88.50Angio, not otherwise specified
B2000ZZ Plain Radiography of Single Coronary Artery using High Osmolar Contrast
B2001ZZ Plain Radiography of Single Coronary Artery using Low Osmolar Contrast
B200YZZ Plain Radiography of Single Coronary Artery using Other Contrast
B2010ZZ Plain Radiography of Multiple Coronary Arteries using High Osmolar Contrast
B2011ZZ Plain Radiography of Multiple Coronary Arteries using Low Osmolar Contrast
B201YZZ Plain Radiography of Multiple Coronary Arteries using Other Contrast
B2020ZZ Plain Radiography of Single Coronary Artery Bypass Graft using High Osmolar Contrast
B2021ZZ Plain Radiography of Single Coronary Artery Bypass Graft using Low Osmolar Contrast
B202YZZ Plain Radiography of Single Coronary Artery Bypass Graft using Other Contrast
B2030ZZ Plain Radiography of Multiple Coronary Artery Bypass Grafts using High Osmolar Contrast
B2031ZZ Plain Radiography of Multiple Coronary Artery Bypass Grafts using Low Osmolar Contrast
B203YZZ Plain Radiography of Multiple Coronary Artery Bypass Grafts using Other Contrast
B2070ZZ Plain Radiography of Right Internal Mammary Bypass Graft using High Osmolar Contrast
B2071ZZ Plain Radiography of Right Internal Mammary Bypass Graft using Low Osmolar Contrast
B207YZZ Plain Radiography of Right Internal Mammary Bypass Graft using Other Contrast
B2080ZZ Plain Radiography of Left Internal Mammary Bypass Graft using High Osmolar Contrast
B2081ZZ Plain Radiography of Left Internal Mammary Bypass Graft using Low Osmolar Contrast
B208YZZ Plain Radiography of Left Internal Mammary Bypass Graft using Other Contrast
B20F0ZZ Plain Radiography of Other Bypass Graft using High Osmolar Contrast
B20F1ZZ Plain Radiography of Other Bypass Graft using Low Osmolar Contrast
B20FYZZ Plain Radiography of Other Bypass Graft using Other Contrast
B2100ZZ Fluoroscopy of Single Coronary Artery using High Osmolar Contrast
B2101ZZ Fluoroscopy of Single Coronary Artery using Low Osmolar Contrast
B210YZZ Fluoroscopy of Single Coronary Artery using Other Contrast
B2110ZZ Fluoroscopy of Multiple Coronary Arteries using High Osmolar Contrast
B2111ZZ Fluoroscopy of Multiple Coronary Arteries using Low Osmolar Contrast
B211YZZ Fluoroscopy of Multiple Coronary Arteries using Other Contrast
B2120ZZ Fluoroscopy of Single Coronary Artery Bypass Graft using High Osmolar Contrast
B2121ZZ Fluoroscopy of Single Coronary Artery Bypass Graft using Low Osmolar Contrast
B212YZZ Fluoroscopy of Single Coronary Artery Bypass Graft using Other Contrast
B2130ZZ Fluoroscopy of Multiple Coronary Artery Bypass Grafts using High Osmolar Contrast
B2131ZZ Fluoroscopy of Multiple Coronary Artery Bypass Grafts using Low Osmolar Contrast
B213YZZ Fluoroscopy of Multiple Coronary Artery Bypass Grafts using Other Contrast
B2170ZZ Fluoroscopy of Right Internal Mammary Bypass Graft using High Osmolar Contrast
B2171ZZ Fluoroscopy of Right Internal Mammary Bypass Graft using Low Osmolar Contrast
B217YZZ Fluoroscopy of Right Internal Mammary Bypass Graft using Other Contrast
B2180ZZ Fluoroscopy of Left Internal Mammary Bypass Graft using High Osmolar Contrast
B2181ZZ Fluoroscopy of Left Internal Mammary Bypass Graft using Low Osmolar Contrast
B218YZZ Fluoroscopy of Left Internal Mammary Bypass Graft using Other Contrast
B21F0ZZ Fluoroscopy of Other Bypass Graft using High Osmolar Contrast
B21F1ZZ Fluoroscopy of Other Bypass Graft using Low Osmolar Contrast
B21FYZZ Fluoroscopy of Other Bypass Graft using Other Contrast
88.53Angio of left heart structures
B2050ZZ Plain Radiography of Left Heart using High Osmolar Contrast
B2051ZZ Plain Radiography of Left Heart using Low Osmolar Contrast
B205YZZ Plain Radiography of Left Heart using Other Contrast
B2150ZZ Fluoroscopy of Left Heart using High Osmolar Contrast
B2151ZZ Fluoroscopy of Left Heart using Low Osmolar Contrast
B215YZZ Fluoroscopy of Left Heart using Other Contrast
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 13
Neuromodulation
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 14
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
03.93Implantation or Replacement of Spinal Neurostimulator Lead(s)
Insertion/Spinal Canal
00HU0MZ Insertion of Neurostimulator Lead into Spinal Canal, Open Approach
00HU3MZInsertion of Neurostimulator Lead into Spinal Canal, Percutaneous Approach
00HU4MZInsertion of Neurostimulator Lead into Spinal Canal, Percutaneous Endoscopic Approach
86.98Insertion or Replacement of Multiple Array (two or more) Rechargeable Neurostimulator Pulse Generator
Insertion/Subcutaneous Tissue and Fascia, Back
0JH70EZInsertion of Multiple Array Rechargeable Stimulator Generator into Back Subcutaneous Tissue and Fascia, Open Approach
0JH73EZInsertion of Multiple Array Rechargeable Stimulator Generator into Back Subcutaneous Tissue and Fascia, Percutaneous Approach
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
02LS3DZ Occlusion of Right Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02LS3ZZ Occlusion of Right Pulmonary Vein, Percutaneous Approach
02LT3DZ Occlusion of Left Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02LT3ZZ Occlusion of Left Pulmonary Vein, Percutaneous Approach
02VP3DZ Restriction of Pulmonary Trunk with Intraluminal Device, Percutaneous Approach
02VP3ZZ Restriction of Pulmonary Trunk, Percutaneous Approach
02VQ3DZ Restriction of Right Pulmonary Artery with Intraluminal Device, Percutaneous Approach
02VQ3ZZ Restriction of Right Pulmonary Artery, Percutaneous Approach
02VR3DT Restriction of Ductus Arteriosus with Intraluminal Device, Percutaneous Approach
02VR3DZ Restriction of Left Pulmonary Artery with Intraluminal Device, Percutaneous Approach
02VR3ZT Restriction of Ductus Arteriosus, Percutaneous Approach
02VR3ZZ Restriction of Left Pulmonary Artery, Percutaneous Approach
02VS3DZ Restriction of Right Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02VS3ZZ Restriction of Right Pulmonary Vein, Percutaneous Approach
02VT3DZ Restriction of Left Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02VT3ZZ Restriction of Left Pulmonary Vein, Percutaneous Approach
02VW3DZ Restriction of Thoracic Aorta with Intraluminal Device, Percutaneous Approach
02VW3ZZ Restriction of Thoracic Aorta, Percutaneous Approach
03L03ZZ Occlusion of Right Internal Mammary Artery, Percutaneous Approach
03L13ZZ Occlusion of Left Internal Mammary Artery, Percutaneous Approach
03L23ZZ Occlusion of Innominate Artery, Percutaneous Approach
03L33ZZ Occlusion of Right Subclavian Artery, Percutaneous Approach
03L43ZZ Occlusion of Left Subclavian Artery, Percutaneous Approach
03L50DZ Occlusion of Right Axillary Artery with Intraluminal Device, Open Approach
03L53DZ Occlusion of Right Axillary Artery with Intraluminal Device, Percutaneous Approach
03L53ZZ Occlusion of Right Axillary Artery, Percutaneous Approach
03L54DZ Occlusion of Right Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L60DZ Occlusion of Left Axillary Artery with Intraluminal Device, Open Approach
03L63DZ Occlusion of Left Axillary Artery with Intraluminal Device, Percutaneous Approach
03L63ZZ Occlusion of Left Axillary Artery, Percutaneous Approach
03L64DZ Occlusion of Left Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L70DZ Occlusion of Right Brachial Artery with Intraluminal Device, Open Approach
03L73DZ Occlusion of Right Brachial Artery with Intraluminal Device, Percutaneous Approach
03L73ZZ Occlusion of Right Brachial Artery, Percutaneous Approach
03L74DZ Occlusion of Right Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L80DZ Occlusion of Left Brachial Artery with Intraluminal Device, Open Approach
03L83DZ Occlusion of Left Brachial Artery with Intraluminal Device, Percutaneous Approach
03L83ZZ Occlusion of Left Brachial Artery, Percutaneous Approach
03L84DZ Occlusion of Left Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L90DZ Occlusion of Right Ulnar Artery with Intraluminal Device, Open Approach
03L93DZ Occlusion of Right Ulnar Artery with Intraluminal Device, Percutaneous Approach
03L93ZZ Occlusion of Right Ulnar Artery, Percutaneous Approach
03L94DZ Occlusion of Right Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LA0DZ Occlusion of Left Ulnar Artery with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 15
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03LA3DZ Occlusion of Left Ulnar Artery with Intraluminal Device, Percutaneous Approach
03LA3ZZ Occlusion of Left Ulnar Artery, Percutaneous Approach
03LA4DZ Occlusion of Left Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LB0DZ Occlusion of Right Radial Artery with Intraluminal Device, Open Approach
03LB3DZ Occlusion of Right Radial Artery with Intraluminal Device, Percutaneous Approach
03LB3ZZ Occlusion of Right Radial Artery, Percutaneous Approach
03LB4DZ Occlusion of Right Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LC0DZ Occlusion of Left Radial Artery with Intraluminal Device, Open Approach
03LC3DZ Occlusion of Left Radial Artery with Intraluminal Device, Percutaneous Approach
03LC3ZZ Occlusion of Left Radial Artery, Percutaneous Approach
03LC4DZ Occlusion of Left Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LD0DZ Occlusion of Right Hand Artery with Intraluminal Device, Open Approach
03LD3DZ Occlusion of Right Hand Artery with Intraluminal Device, Percutaneous Approach
03LD3ZZ Occlusion of Right Hand Artery, Percutaneous Approach
03LD4DZ Occlusion of Right Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LF0DZ Occlusion of Left Hand Artery with Intraluminal Device, Open Approach
03LF3DZ Occlusion of Left Hand Artery with Intraluminal Device, Percutaneous Approach
03LF3ZZ Occlusion of Left Hand Artery, Percutaneous Approach
03LF4DZ Occlusion of Left Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LG3ZZ Occlusion of Intracranial Artery, Percutaneous Approach
03LH3ZZ Occlusion of Right Common Carotid Artery, Percutaneous Approach
03LJ3ZZ Occlusion of Left Common Carotid Artery, Percutaneous Approach
03LK3ZZ Occlusion of Right Internal Carotid Artery, Percutaneous Approach
03LL3ZZ Occlusion of Left Internal Carotid Artery, Percutaneous Approach
03LM3ZZ Occlusion of Right External Carotid Artery, Percutaneous Approach
03LN3ZZ Occlusion of Left External Carotid Artery, Percutaneous Approach
03LP3ZZ Occlusion of Right Vertebral Artery, Percutaneous Approach
03LQ3ZZ Occlusion of Left Vertebral Artery, Percutaneous Approach
03LR3ZZ Occlusion of Face Artery, Percutaneous Approach
03LS3ZZ Occlusion of Right Temporal Artery, Percutaneous Approach
03LT3ZZ Occlusion of Left Temporal Artery, Percutaneous Approach
03LU3ZZ Occlusion of Right Thyroid Artery, Percutaneous Approach
03LV3ZZ Occlusion of Left Thyroid Artery, Percutaneous Approach
03LY0DZ Occlusion of Upper Artery with Intraluminal Device, Open Approach
03LY3DZ Occlusion of Upper Artery with Intraluminal Device, Percutaneous Approach
03LY3ZZ Occlusion of Upper Artery, Percutaneous Approach
03LY4DZ Occlusion of Upper Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V00DZ Restriction of Right Internal Mammary Artery with Intraluminal Device, Open Approach
03V03DZ Restriction of Right Internal Mammary Artery with Intraluminal Device, Percutaneous Approach
03V03ZZ Restriction of Right Internal Mammary Artery, Percutaneous Approach
03V04DZ Restriction of Right Internal Mammary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V10DZ Restriction of Left Internal Mammary Artery with Intraluminal Device, Open Approach
03V13DZ Restriction of Left Internal Mammary Artery with Intraluminal Device, Percutaneous Approach
03V13ZZ Restriction of Left Internal Mammary Artery, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 16
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03V14DZ Restriction of Left Internal Mammary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V20DZ Restriction of Innominate Artery with Intraluminal Device, Open Approach
03V23DZ Restriction of Innominate Artery with Intraluminal Device, Percutaneous Approach
03V23ZZ Restriction of Innominate Artery, Percutaneous Approach
03V24DZ Restriction of Innominate Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V30DZ Restriction of Right Subclavian Artery with Intraluminal Device, Open Approach
03V33DZ Restriction of Right Subclavian Artery with Intraluminal Device, Percutaneous Approach
03V33ZZ Restriction of Right Subclavian Artery, Percutaneous Approach
03V34DZ Restriction of Right Subclavian Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V40DZ Restriction of Left Subclavian Artery with Intraluminal Device, Open Approach
03V43DZ Restriction of Left Subclavian Artery with Intraluminal Device, Percutaneous Approach
03V43ZZ Restriction of Left Subclavian Artery, Percutaneous Approach
03V44DZ Restriction of Left Subclavian Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V50DZ Restriction of Right Axillary Artery with Intraluminal Device, Open Approach
03V53DZ Restriction of Right Axillary Artery with Intraluminal Device, Percutaneous Approach
03V53ZZ Restriction of Right Axillary Artery, Percutaneous Approach
03V54DZ Restriction of Right Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V60DZ Restriction of Left Axillary Artery with Intraluminal Device, Open Approach
03V63DZ Restriction of Left Axillary Artery with Intraluminal Device, Percutaneous Approach
03V63ZZ Restriction of Left Axillary Artery, Percutaneous Approach
03V64DZ Restriction of Left Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V70DZ Restriction of Right Brachial Artery with Intraluminal Device, Open Approach
03V73DZ Restriction of Right Brachial Artery with Intraluminal Device, Percutaneous Approach
03V73ZZ Restriction of Right Brachial Artery, Percutaneous Approach
03V74DZ Restriction of Right Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V80DZ Restriction of Left Brachial Artery with Intraluminal Device, Open Approach
03V83DZ Restriction of Left Brachial Artery with Intraluminal Device, Percutaneous Approach
03V83ZZ Restriction of Left Brachial Artery, Percutaneous Approach
03V84DZ Restriction of Left Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V90DZ Restriction of Right Ulnar Artery with Intraluminal Device, Open Approach
03V93DZ Restriction of Right Ulnar Artery with Intraluminal Device, Percutaneous Approach
03V93ZZ Restriction of Right Ulnar Artery, Percutaneous Approach
03V94DZ Restriction of Right Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VA0DZ Restriction of Left Ulnar Artery with Intraluminal Device, Open Approach
03VA3DZ Restriction of Left Ulnar Artery with Intraluminal Device, Percutaneous Approach
03VA3ZZ Restriction of Left Ulnar Artery, Percutaneous Approach
03VA4DZ Restriction of Left Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VB0DZ Restriction of Right Radial Artery with Intraluminal Device, Open Approach
03VB3DZ Restriction of Right Radial Artery with Intraluminal Device, Percutaneous Approach
03VB3ZZ Restriction of Right Radial Artery, Percutaneous Approach
03VB4DZ Restriction of Right Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VC0DZ Restriction of Left Radial Artery with Intraluminal Device, Open Approach
03VC3DZ Restriction of Left Radial Artery with Intraluminal Device, Percutaneous Approach
03VC3ZZ Restriction of Left Radial Artery, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 17
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03VC4DZ Restriction of Left Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VD0DZ Restriction of Right Hand Artery with Intraluminal Device, Open Approach
03VD3DZ Restriction of Right Hand Artery with Intraluminal Device, Percutaneous Approach
03VD3ZZ Restriction of Right Hand Artery, Percutaneous Approach
03VD4DZ Restriction of Right Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VF0DZ Restriction of Left Hand Artery with Intraluminal Device, Open Approach
03VF3DZ Restriction of Left Hand Artery with Intraluminal Device, Percutaneous Approach
03VF3ZZ Restriction of Left Hand Artery, Percutaneous Approach
03VF4DZ Restriction of Left Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VG3ZZ Restriction of Intracranial Artery, Percutaneous Approach
03VH3ZZ Restriction of Right Common Carotid Artery, Percutaneous Approach
03VJ3ZZ Restriction of Left Common Carotid Artery, Percutaneous Approach
03VK3ZZ Restriction of Right Internal Carotid Artery, Percutaneous Approach
03VL3ZZ Restriction of Left Internal Carotid Artery, Percutaneous Approach
03VM3ZZ Restriction of Right External Carotid Artery, Percutaneous Approach
03VN3ZZ Restriction of Left External Carotid Artery, Percutaneous Approach
03VP3ZZ Restriction of Right Vertebral Artery, Percutaneous Approach
03VQ3ZZ Restriction of Left Vertebral Artery, Percutaneous Approach
03VR3ZZ Restriction of Face Artery, Percutaneous Approach
03VS3ZZ Restriction of Right Temporal Artery, Percutaneous Approach
03VT3ZZ Restriction of Left Temporal Artery, Percutaneous Approach
03VU3ZZ Restriction of Right Thyroid Artery, Percutaneous Approach
03VV3ZZ Restriction of Left Thyroid Artery, Percutaneous Approach
03VY0DZ Restriction of Upper Artery with Intraluminal Device, Open Approach
03VY3DZ Restriction of Upper Artery with Intraluminal Device, Percutaneous Approach
03VY3ZZ Restriction of Upper Artery, Percutaneous Approach
03VY4DZ Restriction of Upper Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04L03ZZ Occlusion of Abdominal Aorta, Percutaneous Approach
04L13ZZ Occlusion of Celiac Artery, Percutaneous Approach
04L23ZZ Occlusion of Gastric Artery, Percutaneous Approach
04L33ZZ Occlusion of Hepatic Artery, Percutaneous Approach
04L43ZZ Occlusion of Splenic Artery, Percutaneous Approach
04L53ZZ Occlusion of Superior Mesenteric Artery, Percutaneous Approach
04L63ZZ Occlusion of Right Colic Artery, Percutaneous Approach
04L73ZZ Occlusion of Left Colic Artery, Percutaneous Approach
04L83ZZ Occlusion of Middle Colic Artery, Percutaneous Approach
04L93ZZ Occlusion of Right Renal Artery, Percutaneous Approach
04LA3ZZ Occlusion of Left Renal Artery, Percutaneous Approach
04LB3ZZ Occlusion of Inferior Mesenteric Artery, Percutaneous Approach
04LC0DZ Occlusion of Right Common Iliac Artery with Intraluminal Device, Open Approach
04LC3DZ Occlusion of Right Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04LC3ZZ Occlusion of Right Common Iliac Artery, Percutaneous Approach
04LC4DZ Occlusion of Right Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LD0DZ Occlusion of Left Common Iliac Artery with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 18
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04LD3DZ Occlusion of Left Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04LD3ZZ Occlusion of Left Common Iliac Artery, Percutaneous Approach
04LD4DZ Occlusion of Left Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LE0DZ Occlusion of Right Internal Iliac Artery with Intraluminal Device, Open Approach
04LE3DZ Occlusion of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04LE3ZZ Occlusion of Right Internal Iliac Artery, Percutaneous Approach
04LE4DZ Occlusion of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LF0DZ Occlusion of Left Internal Iliac Artery with Intraluminal Device, Open Approach
04LF3DZ Occlusion of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04LF3ZZ Occlusion of Left Internal Iliac Artery, Percutaneous Approach
04LF4DZ Occlusion of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LH0DZ Occlusion of Right External Iliac Artery with Intraluminal Device, Open Approach
04LH3DZ Occlusion of Right External Iliac Artery with Intraluminal Device, Percutaneous Approach
04LH3ZZ Occlusion of Right External Iliac Artery, Percutaneous Approach
04LH4DZ Occlusion of Right External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LJ0DZ Occlusion of Left External Iliac Artery with Intraluminal Device, Open Approach
04LJ3DZ Occlusion of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach
04LJ3ZZ Occlusion of Left External Iliac Artery, Percutaneous Approach
04LJ4DZ Occlusion of Left External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LK0DZ Occlusion of Right Femoral Artery with Intraluminal Device, Open Approach
04LK3DZ Occlusion of Right Femoral Artery with Intraluminal Device, Percutaneous Approach
04LK3ZZ Occlusion of Right Femoral Artery, Percutaneous Approach
04LK4DZ Occlusion of Right Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LL0DZ Occlusion of Left Femoral Artery with Intraluminal Device, Open Approach
04LL3DZ Occlusion of Left Femoral Artery with Intraluminal Device, Percutaneous Approach
04LL3ZZ Occlusion of Left Femoral Artery, Percutaneous Approach
04LL4DZ Occlusion of Left Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LM0DZ Occlusion of Right Popliteal Artery with Intraluminal Device, Open Approach
04LM3DZ Occlusion of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach
04LM3ZZ Occlusion of Right Popliteal Artery, Percutaneous Approach
04LM4DZ Occlusion of Right Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LN0DZ Occlusion of Left Popliteal Artery with Intraluminal Device, Open Approach
04LN3DZ Occlusion of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach
04LN3ZZ Occlusion of Left Popliteal Artery, Percutaneous Approach
04LN4DZ Occlusion of Left Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LP0DZ Occlusion of Right Anterior Tibial Artery with Intraluminal Device, Open Approach
04LP3DZ Occlusion of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LP3ZZ Occlusion of Right Anterior Tibial Artery, Percutaneous Approach
04LP4DZ Occlusion of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LQ0DZ Occlusion of Left Anterior Tibial Artery with Intraluminal Device, Open Approach
04LQ3DZ Occlusion of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LQ3ZZ Occlusion of Left Anterior Tibial Artery, Percutaneous Approach
04LQ4DZ Occlusion of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LR0DZ Occlusion of Right Posterior Tibial Artery with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 19
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04LR3DZ Occlusion of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LR3ZZ Occlusion of Right Posterior Tibial Artery, Percutaneous Approach
04LR4DZ Occlusion of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LS0DZ Occlusion of Left Posterior Tibial Artery with Intraluminal Device, Open Approach
04LS3DZ Occlusion of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LS3ZZ Occlusion of Left Posterior Tibial Artery, Percutaneous Approach
04LS4DZ Occlusion of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LT0DZ Occlusion of Right Peroneal Artery with Intraluminal Device, Open Approach
04LT3DZ Occlusion of Right Peroneal Artery with Intraluminal Device, Percutaneous Approach
04LT3ZZ Occlusion of Right Peroneal Artery, Percutaneous Approach
04LT4DZ Occlusion of Right Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LU0DZ Occlusion of Left Peroneal Artery with Intraluminal Device, Open Approach
04LU3DZ Occlusion of Left Peroneal Artery with Intraluminal Device, Percutaneous Approach
04LU3ZZ Occlusion of Left Peroneal Artery, Percutaneous Approach
04LU4DZ Occlusion of Left Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LV0DZ Occlusion of Right Foot Artery with Intraluminal Device, Open Approach
04LV3DZ Occlusion of Right Foot Artery with Intraluminal Device, Percutaneous Approach
04LV3ZZ Occlusion of Right Foot Artery, Percutaneous Approach
04LV4DZ Occlusion of Right Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LW0DZ Occlusion of Left Foot Artery with Intraluminal Device, Open Approach
04LW3DZ Occlusion of Left Foot Artery with Intraluminal Device, Percutaneous Approach
04LW3ZZ Occlusion of Left Foot Artery, Percutaneous Approach
04LW4DZ Occlusion of Left Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LY0DZ Occlusion of Lower Artery with Intraluminal Device, Open Approach
04LY3DZ Occlusion of Lower Artery with Intraluminal Device, Percutaneous Approach
04LY3ZZ Occlusion of Lower Artery, Percutaneous Approach
04LY4DZ Occlusion of Lower Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V03ZZ Restriction of Abdominal Aorta, Percutaneous Approach
04V10DZ Restriction of Celiac Artery with Intraluminal Device, Open Approach
04V13DZ Restriction of Celiac Artery with Intraluminal Device, Percutaneous Approach
04V13ZZ Restriction of Celiac Artery, Percutaneous Approach
04V14DZ Restriction of Celiac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V20DZ Restriction of Gastric Artery with Intraluminal Device, Open Approach
04V23DZ Restriction of Gastric Artery with Intraluminal Device, Percutaneous Approach
04V23ZZ Restriction of Gastric Artery, Percutaneous Approach
04V24DZ Restriction of Gastric Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V30DZ Restriction of Hepatic Artery with Intraluminal Device, Open Approach
04V33DZ Restriction of Hepatic Artery with Intraluminal Device, Percutaneous Approach
04V33ZZ Restriction of Hepatic Artery, Percutaneous Approach
04V34DZ Restriction of Hepatic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V40DZ Restriction of Splenic Artery with Intraluminal Device, Open Approach
04V43DZ Restriction of Splenic Artery with Intraluminal Device, Percutaneous Approach
04V43ZZ Restriction of Splenic Artery, Percutaneous Approach
04V44DZ Restriction of Splenic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 20
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04V50DZ Restriction of Superior Mesenteric Artery with Intraluminal Device, Open Approach
04V53DZ Restriction of Superior Mesenteric Artery with Intraluminal Device, Percutaneous Approach
04V53ZZ Restriction of Superior Mesenteric Artery, Percutaneous Approach
04V54DZ Restriction of Superior Mesenteric Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V60DZ Restriction of Right Colic Artery with Intraluminal Device, Open Approach
04V63DZ Restriction of Right Colic Artery with Intraluminal Device, Percutaneous Approach
04V63ZZ Restriction of Right Colic Artery, Percutaneous Approach
04V64DZ Restriction of Right Colic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V70DZ Restriction of Left Colic Artery with Intraluminal Device, Open Approach
04V73DZ Restriction of Left Colic Artery with Intraluminal Device, Percutaneous Approach
04V73ZZ Restriction of Left Colic Artery, Percutaneous Approach
04V74DZ Restriction of Left Colic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V80DZ Restriction of Middle Colic Artery with Intraluminal Device, Open Approach
04V83DZ Restriction of Middle Colic Artery with Intraluminal Device, Percutaneous Approach
04V83ZZ Restriction of Middle Colic Artery, Percutaneous Approach
04V84DZ Restriction of Middle Colic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V90DZ Restriction of Right Renal Artery with Intraluminal Device, Open Approach
04V93DZ Restriction of Right Renal Artery with Intraluminal Device, Percutaneous Approach
04V93ZZ Restriction of Right Renal Artery, Percutaneous Approach
04V94DZ Restriction of Right Renal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VA0DZ Restriction of Left Renal Artery with Intraluminal Device, Open Approach
04VA3DZ Restriction of Left Renal Artery with Intraluminal Device, Percutaneous Approach
04VA3ZZ Restriction of Left Renal Artery, Percutaneous Approach
04VA4DZ Restriction of Left Renal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VB0DZ Restriction of Inferior Mesenteric Artery with Intraluminal Device, Open Approach
04VB3DZ Restriction of Inferior Mesenteric Artery with Intraluminal Device, Percutaneous Approach
04VB3ZZ Restriction of Inferior Mesenteric Artery, Percutaneous Approach
04VB4DZ Restriction of Inferior Mesenteric Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VC0DZ Restriction of Right Common Iliac Artery with Intraluminal Device, Open Approach
04VC3DZ Restriction of Right Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04VC3ZZ Restriction of Right Common Iliac Artery, Percutaneous Approach
04VC4DZ Restriction of Right Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VD0DZ Restriction of Left Common Iliac Artery with Intraluminal Device, Open Approach
04VD3DZ Restriction of Left Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04VD3ZZ Restriction of Left Common Iliac Artery, Percutaneous Approach
04VD4DZ Restriction of Left Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VE0DZ Restriction of Right Internal Iliac Artery with Intraluminal Device, Open Approach
04VE3DZ Restriction of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04VE3ZZ Restriction of Right Internal Iliac Artery, Percutaneous Approach
04VE4DZ Restriction of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VF0DZ Restriction of Left Internal Iliac Artery with Intraluminal Device, Open Approach
04VF3DZ Restriction of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04VF3ZZ Restriction of Left Internal Iliac Artery, Percutaneous Approach
04VF4DZ Restriction of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 21
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04VH0DZ Restriction of Right External Iliac Artery with Intraluminal Device, Open Approach
04VH3DZ Restriction of Right External Iliac Artery with Intraluminal Device, Percutaneous Approach
04VH3ZZ Restriction of Right External Iliac Artery, Percutaneous Approach
04VH4DZ Restriction of Right External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VJ0DZ Restriction of Left External Iliac Artery with Intraluminal Device, Open Approach
04VJ3DZ Restriction of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach
04VJ3ZZ Restriction of Left External Iliac Artery, Percutaneous Approach
04VJ4DZ Restriction of Left External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VK0DZ Restriction of Right Femoral Artery with Intraluminal Device, Open Approach
04VK3DZ Restriction of Right Femoral Artery with Intraluminal Device, Percutaneous Approach
04VK3ZZ Restriction of Right Femoral Artery, Percutaneous Approach
04VK4DZ Restriction of Right Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VL0DZ Restriction of Left Femoral Artery with Intraluminal Device, Open Approach
04VL3DZ Restriction of Left Femoral Artery with Intraluminal Device, Percutaneous Approach
04VL3ZZ Restriction of Left Femoral Artery, Percutaneous Approach
04VL4DZ Restriction of Left Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VM0DZ Restriction of Right Popliteal Artery with Intraluminal Device, Open Approach
04VM3DZ Restriction of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach
04VM3ZZ Restriction of Right Popliteal Artery, Percutaneous Approach
04VM4DZ Restriction of Right Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VN0DZ Restriction of Left Popliteal Artery with Intraluminal Device, Open Approach
04VN3DZ Restriction of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach
04VN3ZZ Restriction of Left Popliteal Artery, Percutaneous Approach
04VN4DZ Restriction of Left Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VP0DZ Restriction of Right Anterior Tibial Artery with Intraluminal Device, Open Approach
04VP3DZ Restriction of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VP3ZZ Restriction of Right Anterior Tibial Artery, Percutaneous Approach
04VP4DZ Restriction of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VQ0DZ Restriction of Left Anterior Tibial Artery with Intraluminal Device, Open Approach
04VQ3DZ Restriction of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VQ3ZZ Restriction of Left Anterior Tibial Artery, Percutaneous Approach
04VQ4DZ Restriction of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VR0DZ Restriction of Right Posterior Tibial Artery with Intraluminal Device, Open Approach
04VR3DZ Restriction of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VR3ZZ Restriction of Right Posterior Tibial Artery, Percutaneous Approach
04VR4DZ Restriction of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VS0DZ Restriction of Left Posterior Tibial Artery with Intraluminal Device, Open Approach
04VS3DZ Restriction of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VS3ZZ Restriction of Left Posterior Tibial Artery, Percutaneous Approach
04VS4DZ Restriction of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VT0DZ Restriction of Right Peroneal Artery with Intraluminal Device, Open Approach
04VT3DZ Restriction of Right Peroneal Artery with Intraluminal Device, Percutaneous Approach
04VT3ZZ Restriction of Right Peroneal Artery, Percutaneous Approach
04VT4DZ Restriction of Right Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 22
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04VU0DZ Restriction of Left Peroneal Artery with Intraluminal Device, Open Approach
04VU3DZ Restriction of Left Peroneal Artery with Intraluminal Device, Percutaneous Approach
04VU3ZZ Restriction of Left Peroneal Artery, Percutaneous Approach
04VU4DZ Restriction of Left Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VV0DZ Restriction of Right Foot Artery with Intraluminal Device, Open Approach
04VV3DZ Restriction of Right Foot Artery with Intraluminal Device, Percutaneous Approach
04VV3ZZ Restriction of Right Foot Artery, Percutaneous Approach
04VV4DZ Restriction of Right Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VW0DZ Restriction of Left Foot Artery with Intraluminal Device, Open Approach
04VW3DZ Restriction of Left Foot Artery with Intraluminal Device, Percutaneous Approach
04VW3ZZ Restriction of Left Foot Artery, Percutaneous Approach
04VW4DZ Restriction of Left Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VY0DZ Restriction of Lower Artery with Intraluminal Device, Open Approach
04VY3DZ Restriction of Lower Artery with Intraluminal Device, Percutaneous Approach
04VY3ZZ Restriction of Lower Artery, Percutaneous Approach
04VY4DZ Restriction of Lower Artery with Intraluminal Device, Percutaneous Endoscopic Approach
05L03ZZ Occlusion of Azygos Vein, Percutaneous Approach
05L13ZZ Occlusion of Hemiazygos Vein, Percutaneous Approach
05L33ZZ Occlusion of Right Innominate Vein, Percutaneous Approach
05L43ZZ Occlusion of Left Innominate Vein, Percutaneous Approach
05L53ZZ Occlusion of Right Subclavian Vein, Percutaneous Approach
05L63ZZ Occlusion of Left Subclavian Vein, Percutaneous Approach
05L70DZ Occlusion of Right Axillary Vein with Intraluminal Device, Open Approach
05L73DZ Occlusion of Right Axillary Vein with Intraluminal Device, Percutaneous Approach
05L73ZZ Occlusion of Right Axillary Vein, Percutaneous Approach
05L74DZ Occlusion of Right Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05L80DZ Occlusion of Left Axillary Vein with Intraluminal Device, Open Approach
05L83DZ Occlusion of Left Axillary Vein with Intraluminal Device, Percutaneous Approach
05L83ZZ Occlusion of Left Axillary Vein, Percutaneous Approach
05L84DZ Occlusion of Left Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05L90DZ Occlusion of Right Brachial Vein with Intraluminal Device, Open Approach
05L93DZ Occlusion of Right Brachial Vein with Intraluminal Device, Percutaneous Approach
05L93ZZ Occlusion of Right Brachial Vein, Percutaneous Approach
05L94DZ Occlusion of Right Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LA0DZ Occlusion of Left Brachial Vein with Intraluminal Device, Open Approach
05LA3DZ Occlusion of Left Brachial Vein with Intraluminal Device, Percutaneous Approach
05LA3ZZ Occlusion of Left Brachial Vein, Percutaneous Approach
05LA4DZ Occlusion of Left Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LB0DZ Occlusion of Right Basilic Vein with Intraluminal Device, Open Approach
05LB3DZ Occlusion of Right Basilic Vein with Intraluminal Device, Percutaneous Approach
05LB3ZZ Occlusion of Right Basilic Vein, Percutaneous Approach
05LB4DZ Occlusion of Right Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LC0DZ Occlusion of Left Basilic Vein with Intraluminal Device, Open Approach
05LC3DZ Occlusion of Left Basilic Vein with Intraluminal Device, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 23
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05LC3ZZ Occlusion of Left Basilic Vein, Percutaneous Approach
05LC4DZ Occlusion of Left Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LD0DZ Occlusion of Right Cephalic Vein with Intraluminal Device, Open Approach
05LD3DZ Occlusion of Right Cephalic Vein with Intraluminal Device, Percutaneous Approach
05LD3ZZ Occlusion of Right Cephalic Vein, Percutaneous Approach
05LD4DZ Occlusion of Right Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LF0DZ Occlusion of Left Cephalic Vein with Intraluminal Device, Open Approach
05LF3DZ Occlusion of Left Cephalic Vein with Intraluminal Device, Percutaneous Approach
05LF3ZZ Occlusion of Left Cephalic Vein, Percutaneous Approach
05LF4DZ Occlusion of Left Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LG0DZ Occlusion of Right Hand Vein with Intraluminal Device, Open Approach
05LG3DZ Occlusion of Right Hand Vein with Intraluminal Device, Percutaneous Approach
05LG3ZZ Occlusion of Right Hand Vein, Percutaneous Approach
05LG4DZ Occlusion of Right Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LH0DZ Occlusion of Left Hand Vein with Intraluminal Device, Open Approach
05LH3DZ Occlusion of Left Hand Vein with Intraluminal Device, Percutaneous Approach
05LH3ZZ Occlusion of Left Hand Vein, Percutaneous Approach
05LH4DZ Occlusion of Left Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LL3ZZ Occlusion of Intracranial Vein, Percutaneous Approach
05LM3ZZ Occlusion of Right Internal Jugular Vein, Percutaneous Approach
05LN3ZZ Occlusion of Left Internal Jugular Vein, Percutaneous Approach
05LP3ZZ Occlusion of Right External Jugular Vein, Percutaneous Approach
05LQ3ZZ Occlusion of Left External Jugular Vein, Percutaneous Approach
05LR3ZZ Occlusion of Right Vertebral Vein, Percutaneous Approach
05LS3ZZ Occlusion of Left Vertebral Vein, Percutaneous Approach
05LT3ZZ Occlusion of Right Face Vein, Percutaneous Approach
05LV3ZZ Occlusion of Left Face Vein, Percutaneous Approach
05LY0DZ Occlusion of Upper Vein with Intraluminal Device, Open Approach
05LY3ZZ Occlusion of Upper Vein, Percutaneous Approach
05V00DZ Restriction of Azygos Vein with Intraluminal Device, Open Approach
05V03DZ Restriction of Azygos Vein with Intraluminal Device, Percutaneous Approach
05V03ZZ Restriction of Azygos Vein, Percutaneous Approach
05V04DZ Restriction of Azygos Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V10DZ Restriction of Hemiazygos Vein with Intraluminal Device, Open Approach
05V13DZ Restriction of Hemiazygos Vein with Intraluminal Device, Percutaneous Approach
05V13ZZ Restriction of Hemiazygos Vein, Percutaneous Approach
05V14DZ Restriction of Hemiazygos Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V30DZ Restriction of Right Innominate Vein with Intraluminal Device, Open Approach
05V33DZ Restriction of Right Innominate Vein with Intraluminal Device, Percutaneous Approach
05V33ZZ Restriction of Right Innominate Vein, Percutaneous Approach
05V34DZ Restriction of Right Innominate Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V40DZ Restriction of Left Innominate Vein with Intraluminal Device, Open Approach
05V43DZ Restriction of Left Innominate Vein with Intraluminal Device, Percutaneous Approach
05V43ZZ Restriction of Left Innominate Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 24
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05V44DZ Restriction of Left Innominate Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V50DZ Restriction of Right Subclavian Vein with Intraluminal Device, Open Approach
05V53DZ Restriction of Right Subclavian Vein with Intraluminal Device, Percutaneous Approach
05V53ZZ Restriction of Right Subclavian Vein, Percutaneous Approach
05V54DZ Restriction of Right Subclavian Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V60DZ Restriction of Left Subclavian Vein with Intraluminal Device, Open Approach
05V63DZ Restriction of Left Subclavian Vein with Intraluminal Device, Percutaneous Approach
05V63ZZ Restriction of Left Subclavian Vein, Percutaneous Approach
05V64DZ Restriction of Left Subclavian Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V70DZ Restriction of Right Axillary Vein with Intraluminal Device, Open Approach
05V73DZ Restriction of Right Axillary Vein with Intraluminal Device, Percutaneous Approach
05V73ZZ Restriction of Right Axillary Vein, Percutaneous Approach
05V74DZ Restriction of Right Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V80DZ Restriction of Left Axillary Vein with Intraluminal Device, Open Approach
05V83DZ Restriction of Left Axillary Vein with Intraluminal Device, Percutaneous Approach
05V83ZZ Restriction of Left Axillary Vein, Percutaneous Approach
05V84DZ Restriction of Left Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V90DZ Restriction of Right Brachial Vein with Intraluminal Device, Open Approach
05V93DZ Restriction of Right Brachial Vein with Intraluminal Device, Percutaneous Approach
05V93ZZ Restriction of Right Brachial Vein, Percutaneous Approach
05V94DZ Restriction of Right Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VA0DZ Restriction of Left Brachial Vein with Intraluminal Device, Open Approach
05VA3DZ Restriction of Left Brachial Vein with Intraluminal Device, Percutaneous Approach
05VA3ZZ Restriction of Left Brachial Vein, Percutaneous Approach
05VA4DZ Restriction of Left Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VB0DZ Restriction of Right Basilic Vein with Intraluminal Device, Open Approach
05VB3DZ Restriction of Right Basilic Vein with Intraluminal Device, Percutaneous Approach
05VB3ZZ Restriction of Right Basilic Vein, Percutaneous Approach
05VB4DZ Restriction of Right Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VC0DZ Restriction of Left Basilic Vein with Intraluminal Device, Open Approach
05VC3DZ Restriction of Left Basilic Vein with Intraluminal Device, Percutaneous Approach
05VC3ZZ Restriction of Left Basilic Vein, Percutaneous Approach
05VC4DZ Restriction of Left Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VD0DZ Restriction of Right Cephalic Vein with Intraluminal Device, Open Approach
05VD3DZ Restriction of Right Cephalic Vein with Intraluminal Device, Percutaneous Approach
05VD3ZZ Restriction of Right Cephalic Vein, Percutaneous Approach
05VD4DZ Restriction of Right Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VF0DZ Restriction of Left Cephalic Vein with Intraluminal Device, Open Approach
05VF3DZ Restriction of Left Cephalic Vein with Intraluminal Device, Percutaneous Approach
05VF3ZZ Restriction of Left Cephalic Vein, Percutaneous Approach
05VF4DZ Restriction of Left Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VG0DZ Restriction of Right Hand Vein with Intraluminal Device, Open Approach
05VG3DZ Restriction of Right Hand Vein with Intraluminal Device, Percutaneous Approach
05VG3ZZ Restriction of Right Hand Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 25
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05VG4DZ Restriction of Right Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VH0DZ Restriction of Left Hand Vein with Intraluminal Device, Open Approach
05VH3DZ Restriction of Left Hand Vein with Intraluminal Device, Percutaneous Approach
05VH3ZZ Restriction of Left Hand Vein, Percutaneous Approach
05VH4DZ Restriction of Left Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VL0DZ Restriction of Intracranial Vein with Intraluminal Device, Open Approach
05VL3DZ Restriction of Intracranial Vein with Intraluminal Device, Percutaneous Approach
05VL3ZZ Restriction of Intracranial Vein, Percutaneous Approach
05VL4DZ Restriction of Intracranial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VM0DZ Restriction of Right Internal Jugular Vein with Intraluminal Device, Open Approach
05VM3DZ Restriction of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Approach
05VM3ZZ Restriction of Right Internal Jugular Vein, Percutaneous Approach
05VM4DZ Restriction of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VN0DZ Restriction of Left Internal Jugular Vein with Intraluminal Device, Open Approach
05VN3DZ Restriction of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Approach
05VN3ZZ Restriction of Left Internal Jugular Vein, Percutaneous Approach
05VN4DZ Restriction of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VP0DZ Restriction of Right External Jugular Vein with Intraluminal Device, Open Approach
05VP3DZ Restriction of Right External Jugular Vein with Intraluminal Device, Percutaneous Approach
05VP3ZZ Restriction of Right External Jugular Vein, Percutaneous Approach
05VP4DZ Restriction of Right External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VQ0DZ Restriction of Left External Jugular Vein with Intraluminal Device, Open Approach
05VQ3DZ Restriction of Left External Jugular Vein with Intraluminal Device, Percutaneous Approach
05VQ3ZZ Restriction of Left External Jugular Vein, Percutaneous Approach
05VQ4DZ Restriction of Left External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VR0DZ Restriction of Right Vertebral Vein with Intraluminal Device, Open Approach
05VR3DZ Restriction of Right Vertebral Vein with Intraluminal Device, Percutaneous Approach
05VR3ZZ Restriction of Right Vertebral Vein, Percutaneous Approach
05VR4DZ Restriction of Right Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VS0DZ Restriction of Left Vertebral Vein with Intraluminal Device, Open Approach
05VS3DZ Restriction of Left Vertebral Vein with Intraluminal Device, Percutaneous Approach
05VS3ZZ Restriction of Left Vertebral Vein, Percutaneous Approach
05VS4DZ Restriction of Left Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VT0DZ Restriction of Right Face Vein with Intraluminal Device, Open Approach
05VT3DZ Restriction of Right Face Vein with Intraluminal Device, Percutaneous Approach
05VT3ZZ Restriction of Right Face Vein, Percutaneous Approach
05VT4DZ Restriction of Right Face Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VV0DZ Restriction of Left Face Vein with Intraluminal Device, Open Approach
05VV3DZ Restriction of Left Face Vein with Intraluminal Device, Percutaneous Approach
05VV3ZZ Restriction of Left Face Vein, Percutaneous Approach
05VV4DZ Restriction of Left Face Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VY3DZ Restriction of Upper Vein with Intraluminal Device, Percutaneous Approach
05VY3ZZ Restriction of Upper Vein, Percutaneous Approach
06L13ZZ Occlusion of Splenic Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 26
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06L23ZZ Occlusion of Gastric Vein, Percutaneous Approach
06L33ZZ Occlusion of Esophageal Vein, Percutaneous Approach
06L43ZZ Occlusion of Hepatic Vein, Percutaneous Approach
06L53ZZ Occlusion of Superior Mesenteric Vein, Percutaneous Approach
06L63ZZ Occlusion of Inferior Mesenteric Vein, Percutaneous Approach
06L73ZZ Occlusion of Colic Vein, Percutaneous Approach
06L83ZZ Occlusion of Portal Vein, Percutaneous Approach
06L93ZZ Occlusion of Right Renal Vein, Percutaneous Approach
06LB3ZZ Occlusion of Left Renal Vein, Percutaneous Approach
06LC0DZ Occlusion of Right Common Iliac Vein with Intraluminal Device, Open Approach
06LC3DZ Occlusion of Right Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06LC3ZZ Occlusion of Right Common Iliac Vein, Percutaneous Approach
06LC4DZ Occlusion of Right Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LD0DZ Occlusion of Left Common Iliac Vein with Intraluminal Device, Open Approach
06LD3DZ Occlusion of Left Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06LD3ZZ Occlusion of Left Common Iliac Vein, Percutaneous Approach
06LD4DZ Occlusion of Left Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LF0DZ Occlusion of Right External Iliac Vein with Intraluminal Device, Open Approach
06LF3DZ Occlusion of Right External Iliac Vein with Intraluminal Device, Percutaneous Approach
06LF3ZZ Occlusion of Right External Iliac Vein, Percutaneous Approach
06LF4DZ Occlusion of Right External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LG0DZ Occlusion of Left External Iliac Vein with Intraluminal Device, Open Approach
06LG3DZ Occlusion of Left External Iliac Vein with Intraluminal Device, Percutaneous Approach
06LG3ZZ Occlusion of Left External Iliac Vein, Percutaneous Approach
06LG4DZ Occlusion of Left External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LH3ZZ Occlusion of Right Hypogastric Vein, Percutaneous Approach
06LJ3ZZ Occlusion of Left Hypogastric Vein, Percutaneous Approach
06LM0DZ Occlusion of Right Femoral Vein with Intraluminal Device, Open Approach
06LM3DZ Occlusion of Right Femoral Vein with Intraluminal Device, Percutaneous Approach
06LM3ZZ Occlusion of Right Femoral Vein, Percutaneous Approach
06LM4DZ Occlusion of Right Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LN0DZ Occlusion of Left Femoral Vein with Intraluminal Device, Open Approach
06LN3DZ Occlusion of Left Femoral Vein with Intraluminal Device, Percutaneous Approach
06LN3ZZ Occlusion of Left Femoral Vein, Percutaneous Approach
06LN4DZ Occlusion of Left Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LP0DZ Occlusion of Right Greater Saphenous Vein with Intraluminal Device, Open Approach
06LP3DZ Occlusion of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LP3ZZ Occlusion of Right Greater Saphenous Vein, Percutaneous Approach
06LP4DZ Occlusion of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LQ0DZ Occlusion of Left Greater Saphenous Vein with Intraluminal Device, Open Approach
06LQ3DZ Occlusion of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LQ3ZZ Occlusion of Left Greater Saphenous Vein, Percutaneous Approach
06LQ4DZ Occlusion of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LR0DZ Occlusion of Right Lesser Saphenous Vein with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 27
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06LR3DZ Occlusion of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LR3ZZ Occlusion of Right Lesser Saphenous Vein, Percutaneous Approach
06LR4DZ Occlusion of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LS0DZ Occlusion of Left Lesser Saphenous Vein with Intraluminal Device, Open Approach
06LS3DZ Occlusion of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LS3ZZ Occlusion of Left Lesser Saphenous Vein, Percutaneous Approach
06LS4DZ Occlusion of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LT0DZ Occlusion of Right Foot Vein with Intraluminal Device, Open Approach
06LT3DZ Occlusion of Right Foot Vein with Intraluminal Device, Percutaneous Approach
06LT3ZZ Occlusion of Right Foot Vein, Percutaneous Approach
06LT4DZ Occlusion of Right Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LV0DZ Occlusion of Left Foot Vein with Intraluminal Device, Open Approach
06LV3DZ Occlusion of Left Foot Vein with Intraluminal Device, Percutaneous Approach
06LV3ZZ Occlusion of Left Foot Vein, Percutaneous Approach
06LV4DZ Occlusion of Left Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LY0DZ Occlusion of Lower Vein with Intraluminal Device, Open Approach
06LY3DZ Occlusion of Lower Vein with Intraluminal Device, Percutaneous Approach
06LY3ZZ Occlusion of Lower Vein, Percutaneous Approach
06LY4DZ Occlusion of Lower Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V10DZ Restriction of Splenic Vein with Intraluminal Device, Open Approach
06V13DZ Restriction of Splenic Vein with Intraluminal Device, Percutaneous Approach
06V13ZZ Restriction of Splenic Vein, Percutaneous Approach
06V14DZ Restriction of Splenic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V20DZ Restriction of Gastric Vein with Intraluminal Device, Open Approach
06V23DZ Restriction of Gastric Vein with Intraluminal Device, Percutaneous Approach
06V23ZZ Restriction of Gastric Vein, Percutaneous Approach
06V24DZ Restriction of Gastric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V30DZ Restriction of Esophageal Vein with Intraluminal Device, Open Approach
06V33DZ Restriction of Esophageal Vein with Intraluminal Device, Percutaneous Approach
06V33ZZ Restriction of Esophageal Vein, Percutaneous Approach
06V34DZ Restriction of Esophageal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V40DZ Restriction of Hepatic Vein with Intraluminal Device, Open Approach
06V43DZ Restriction of Hepatic Vein with Intraluminal Device, Percutaneous Approach
06V43ZZ Restriction of Hepatic Vein, Percutaneous Approach
06V44DZ Restriction of Hepatic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V50DZ Restriction of Superior Mesenteric Vein with Intraluminal Device, Open Approach
06V53DZ Restriction of Superior Mesenteric Vein with Intraluminal Device, Percutaneous Approach
06V53ZZ Restriction of Superior Mesenteric Vein, Percutaneous Approach
06V54DZ Restriction of Superior Mesenteric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V60DZ Restriction of Inferior Mesenteric Vein with Intraluminal Device, Open Approach
06V63DZ Restriction of Inferior Mesenteric Vein with Intraluminal Device, Percutaneous Approach
06V63ZZ Restriction of Inferior Mesenteric Vein, Percutaneous Approach
06V64DZ Restriction of Inferior Mesenteric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V70DZ Restriction of Colic Vein with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 28
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06V73DZ Restriction of Colic Vein with Intraluminal Device, Percutaneous Approach
06V73ZZ Restriction of Colic Vein, Percutaneous Approach
06V74DZ Restriction of Colic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V80DZ Restriction of Portal Vein with Intraluminal Device, Open Approach
06V83DZ Restriction of Portal Vein with Intraluminal Device, Percutaneous Approach
06V83ZZ Restriction of Portal Vein, Percutaneous Approach
06V84DZ Restriction of Portal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V90DZ Restriction of Right Renal Vein with Intraluminal Device, Open Approach
06V93DZ Restriction of Right Renal Vein with Intraluminal Device, Percutaneous Approach
06V93ZZ Restriction of Right Renal Vein, Percutaneous Approach
06V94DZ Restriction of Right Renal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VB0DZ Restriction of Left Renal Vein with Intraluminal Device, Open Approach
06VB3DZ Restriction of Left Renal Vein with Intraluminal Device, Percutaneous Approach
06VB3ZZ Restriction of Left Renal Vein, Percutaneous Approach
06VB4DZ Restriction of Left Renal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VC0DZ Restriction of Right Common Iliac Vein with Intraluminal Device, Open Approach
06VC3DZ Restriction of Right Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06VC3ZZ Restriction of Right Common Iliac Vein, Percutaneous Approach
06VC4DZ Restriction of Right Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VD0DZ Restriction of Left Common Iliac Vein with Intraluminal Device, Open Approach
06VD3DZ Restriction of Left Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06VD3ZZ Restriction of Left Common Iliac Vein, Percutaneous Approach
06VD4DZ Restriction of Left Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VF0DZ Restriction of Right External Iliac Vein with Intraluminal Device, Open Approach
06VF3DZ Restriction of Right External Iliac Vein with Intraluminal Device, Percutaneous Approach
06VF3ZZ Restriction of Right External Iliac Vein, Percutaneous Approach
06VF4DZ Restriction of Right External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VG0DZ Restriction of Left External Iliac Vein with Intraluminal Device, Open Approach
06VG3DZ Restriction of Left External Iliac Vein with Intraluminal Device, Percutaneous Approach
06VG3ZZ Restriction of Left External Iliac Vein, Percutaneous Approach
06VG4DZ Restriction of Left External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VH0DZ Restriction of Right Hypogastric Vein with Intraluminal Device, Open Approach
06VH3DZ Restriction of Right Hypogastric Vein with Intraluminal Device, Percutaneous Approach
06VH3ZZ Restriction of Right Hypogastric Vein, Percutaneous Approach
06VH4DZ Restriction of Right Hypogastric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VJ0DZ Restriction of Left Hypogastric Vein with Intraluminal Device, Open Approach
06VJ3DZ Restriction of Left Hypogastric Vein with Intraluminal Device, Percutaneous Approach
06VJ3ZZ Restriction of Left Hypogastric Vein, Percutaneous Approach
06VJ4DZ Restriction of Left Hypogastric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VM0DZ Restriction of Right Femoral Vein with Intraluminal Device, Open Approach
06VM3DZ Restriction of Right Femoral Vein with Intraluminal Device, Percutaneous Approach
06VM3ZZ Restriction of Right Femoral Vein, Percutaneous Approach
06VM4DZ Restriction of Right Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VN0DZ Restriction of Left Femoral Vein with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 29
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06VN3DZ Restriction of Left Femoral Vein with Intraluminal Device, Percutaneous Approach
06VN3ZZ Restriction of Left Femoral Vein, Percutaneous Approach
06VN4DZ Restriction of Left Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VP0DZ Restriction of Right Greater Saphenous Vein with Intraluminal Device, Open Approach
06VP3DZ Restriction of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VP3ZZ Restriction of Right Greater Saphenous Vein, Percutaneous Approach
06VP4DZ Restriction of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VQ0DZ Restriction of Left Greater Saphenous Vein with Intraluminal Device, Open Approach
06VQ3DZ Restriction of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VQ3ZZ Restriction of Left Greater Saphenous Vein, Percutaneous Approach
06VQ4DZ Restriction of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VR0DZ Restriction of Right Lesser Saphenous Vein with Intraluminal Device, Open Approach
06VR3DZ Restriction of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VR3ZZ Restriction of Right Lesser Saphenous Vein, Percutaneous Approach
06VR4DZ Restriction of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VS0DZ Restriction of Left Lesser Saphenous Vein with Intraluminal Device, Open Approach
06VS3DZ Restriction of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VS3ZZ Restriction of Left Lesser Saphenous Vein, Percutaneous Approach
06VS4DZ Restriction of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VT0DZ Restriction of Right Foot Vein with Intraluminal Device, Open Approach
06VT3DZ Restriction of Right Foot Vein with Intraluminal Device, Percutaneous Approach
06VT3ZZ Restriction of Right Foot Vein, Percutaneous Approach
06VT4DZ Restriction of Right Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VV0DZ Restriction of Left Foot Vein with Intraluminal Device, Open Approach
06VV3DZ Restriction of Left Foot Vein with Intraluminal Device, Percutaneous Approach
06VV3ZZ Restriction of Left Foot Vein, Percutaneous Approach
06VV4DZ Restriction of Left Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VY3DZ Restriction of Lower Vein with Intraluminal Device, Percutaneous Approach
06VY3ZZ Restriction of Lower Vein, Percutaneous Approach
02CP3ZZ Extirpation of Matter from Pulmonary Trunk, Percutaneous Approach
02CQ3ZZ Extirpation of Matter from Right Pulmonary Artery, Percutaneous Approach
02CR3ZZ Extirpation of Matter from Left Pulmonary Artery, Percutaneous Approach
02CS3ZZ Extirpation of Matter from Right Pulmonary Vein, Percutaneous Approach
02CT3ZZ Extirpation of Matter from Left Pulmonary Vein, Percutaneous Approach
02CV3ZZ Extirpation of Matter from Superior Vena Cava, Percutaneous Approach
02CW3ZZ Extirpation of Matter from Thoracic Aorta, Percutaneous Approach
03C03ZZ Extirpation of Matter from Right Internal Mammary Artery, Percutaneous Approach
03C13ZZ Extirpation of Matter from Left Internal Mammary Artery, Percutaneous Approach
03C23ZZ Extirpation of Matter from Innominate Artery, Percutaneous Approach
03C33ZZ Extirpation of Matter from Right Subclavian Artery, Percutaneous Approach
03C43ZZ Extirpation of Matter from Left Subclavian Artery, Percutaneous Approach
03C53ZZ Extirpation of Matter from Right Axillary Artery, Percutaneous Approach
03C63ZZ Extirpation of Matter from Left Axillary Artery, Percutaneous Approach
03C73ZZ Extirpation of Matter from Right Brachial Artery, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 30
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03C83ZZ Extirpation of Matter from Left Brachial Artery, Percutaneous Approach
03C93ZZ Extirpation of Matter from Right Ulnar Artery, Percutaneous Approach
03CA3ZZ Extirpation of Matter from Left Ulnar Artery, Percutaneous Approach
03CB3ZZ Extirpation of Matter from Right Radial Artery, Percutaneous Approach
03CC3ZZ Extirpation of Matter from Left Radial Artery, Percutaneous Approach
03CD3ZZ Extirpation of Matter from Right Hand Artery, Percutaneous Approach
03CF3ZZ Extirpation of Matter from Left Hand Artery, Percutaneous Approach
03CY3ZZ Extirpation of Matter from Upper Artery, Percutaneous Approach
04C03ZZ Extirpation of Matter from Abdominal Aorta, Percutaneous Approach
04C13ZZ Extirpation of Matter from Celiac Artery, Percutaneous Approach
04C23ZZ Extirpation of Matter from Gastric Artery, Percutaneous Approach
04C33ZZ Extirpation of Matter from Hepatic Artery, Percutaneous Approach
04C43ZZ Extirpation of Matter from Splenic Artery, Percutaneous Approach
04C53ZZ Extirpation of Matter from Superior Mesenteric Artery, Percutaneous Approach
04C63ZZ Extirpation of Matter from Right Colic Artery, Percutaneous Approach
04C73ZZ Extirpation of Matter from Left Colic Artery, Percutaneous Approach
04C83ZZ Extirpation of Matter from Middle Colic Artery, Percutaneous Approach
04C93ZZ Extirpation of Matter from Right Renal Artery, Percutaneous Approach
04CA3ZZ Extirpation of Matter from Left Renal Artery, Percutaneous Approach
04CB3ZZ Extirpation of Matter from Inferior Mesenteric Artery, Percutaneous Approach
04CC3ZZ Extirpation of Matter from Right Common Iliac Artery, Percutaneous Approach
04CD3ZZ Extirpation of Matter from Left Common Iliac Artery, Percutaneous Approach
04CE3ZZ Extirpation of Matter from Right Internal Iliac Artery, Percutaneous Approach
04CF3ZZ Extirpation of Matter from Left Internal Iliac Artery, Percutaneous Approach
04CH3ZZ Extirpation of Matter from Right External Iliac Artery, Percutaneous Approach
04CJ3ZZ Extirpation of Matter from Left External Iliac Artery, Percutaneous Approach
04CK3ZZ Extirpation of Matter from Right Femoral Artery, Percutaneous Approach
04CL3ZZ Extirpation of Matter from Left Femoral Artery, Percutaneous Approach
04CM3ZZ Extirpation of Matter from Right Popliteal Artery, Percutaneous Approach
04CN3ZZ Extirpation of Matter from Left Popliteal Artery, Percutaneous Approach
04CP3ZZ Extirpation of Matter from Right Anterior Tibial Artery, Percutaneous Approach
04CQ3ZZ Extirpation of Matter from Left Anterior Tibial Artery, Percutaneous Approach
04CR3ZZ Extirpation of Matter from Right Posterior Tibial Artery, Percutaneous Approach
04CS3ZZ Extirpation of Matter from Left Posterior Tibial Artery, Percutaneous Approach
04CT3ZZ Extirpation of Matter from Right Peroneal Artery, Percutaneous Approach
04CU3ZZ Extirpation of Matter from Left Peroneal Artery, Percutaneous Approach
04CV3ZZ Extirpation of Matter from Right Foot Artery, Percutaneous Approach
04CW3ZZ Extirpation of Matter from Left Foot Artery, Percutaneous Approach
04CY3ZZ Extirpation of Matter from Lower Artery, Percutaneous Approach
05C03ZZ Extirpation of Matter from Azygos Vein, Percutaneous Approach
05C13ZZ Extirpation of Matter from Hemiazygos Vein, Percutaneous Approach
05C33ZZ Extirpation of Matter from Right Innominate Vein, Percutaneous Approach
05C43ZZ Extirpation of Matter from Left Innominate Vein, Percutaneous Approach
05C53ZZ Extirpation of Matter from Right Subclavian Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 31
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05C63ZZ Extirpation of Matter from Left Subclavian Vein, Percutaneous Approach
05C73ZZ Extirpation of Matter from Right Axillary Vein, Percutaneous Approach
05C83ZZ Extirpation of Matter from Left Axillary Vein, Percutaneous Approach
05C93ZZ Extirpation of Matter from Right Brachial Vein, Percutaneous Approach
05CA3ZZ Extirpation of Matter from Left Brachial Vein, Percutaneous Approach
05CB3ZZ Extirpation of Matter from Right Basilic Vein, Percutaneous Approach
05CC3ZZ Extirpation of Matter from Left Basilic Vein, Percutaneous Approach
05CD3ZZ Extirpation of Matter from Right Cephalic Vein, Percutaneous Approach
05CF3ZZ Extirpation of Matter from Left Cephalic Vein, Percutaneous Approach
05CG3ZZ Extirpation of Matter from Right Hand Vein, Percutaneous Approach
05CH3ZZ Extirpation of Matter from Left Hand Vein, Percutaneous Approach
05CL3ZZ Extirpation of Matter from Intracranial Vein, Percutaneous Approach
05CM3ZZ Extirpation of Matter from Right Internal Jugular Vein, Percutaneous Approach
05CN3ZZ Extirpation of Matter from Left Internal Jugular Vein, Percutaneous Approach
05CP3ZZ Extirpation of Matter from Right External Jugular Vein, Percutaneous Approach
05CQ3ZZ Extirpation of Matter from Left External Jugular Vein, Percutaneous Approach
05CR3ZZ Extirpation of Matter from Right Vertebral Vein, Percutaneous Approach
05CS3ZZ Extirpation of Matter from Left Vertebral Vein, Percutaneous Approach
05CT3ZZ Extirpation of Matter from Right Face Vein, Percutaneous Approach
05CV3ZZ Extirpation of Matter from Left Face Vein, Percutaneous Approach
05CY3ZZ Extirpation of Matter from Upper Vein, Percutaneous Approach
06C03ZZ Extirpation of Matter from Inferior Vena Cava, Percutaneous Approach
06C13ZZ Extirpation of Matter from Splenic Vein, Percutaneous Approach
06C23ZZ Extirpation of Matter from Gastric Vein, Percutaneous Approach
06C33ZZ Extirpation of Matter from Esophageal Vein, Percutaneous Approach
06C43ZZ Extirpation of Matter from Hepatic Vein, Percutaneous Approach
06C53ZZ Extirpation of Matter from Superior Mesenteric Vein, Percutaneous Approach
06C63ZZ Extirpation of Matter from Inferior Mesenteric Vein, Percutaneous Approach
06C73ZZ Extirpation of Matter from Colic Vein, Percutaneous Approach
06C83ZZ Extirpation of Matter from Portal Vein, Percutaneous Approach
06C93ZZ Extirpation of Matter from Right Renal Vein, Percutaneous Approach
06CB3ZZ Extirpation of Matter from Left Renal Vein, Percutaneous Approach
06CC3ZZ Extirpation of Matter from Right Common Iliac Vein, Percutaneous Approach
06CD3ZZ Extirpation of Matter from Left Common Iliac Vein, Percutaneous Approach
06CF3ZZ Extirpation of Matter from Right External Iliac Vein, Percutaneous Approach
06CG3ZZ Extirpation of Matter from Left External Iliac Vein, Percutaneous Approach
06CH3ZZ Extirpation of Matter from Right Hypogastric Vein, Percutaneous Approach
06CJ3ZZ Extirpation of Matter from Left Hypogastric Vein, Percutaneous Approach
06CM3ZZ Extirpation of Matter from Right Femoral Vein, Percutaneous Approach
06CN3ZZ Extirpation of Matter from Left Femoral Vein, Percutaneous Approach
06CP3ZZ Extirpation of Matter from Right Greater Saphenous Vein, Percutaneous Approach
06CQ3ZZ Extirpation of Matter from Left Greater Saphenous Vein, Percutaneous Approach
06CR3ZZ Extirpation of Matter from Right Lesser Saphenous Vein, Percutaneous Approach
06CS3ZZ Extirpation of Matter from Left Lesser Saphenous Vein, Percutaneous Approach
06CT3ZZ Extirpation of Matter from Right Foot Vein, Percutaneous Approach
06CV3ZZ Extirpation of Matter from Left Foot Vein, Percutaneous Approach
06CY3ZZ Extirpation of Matter from Lower Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 32
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.50
Angioplasty of other
non-coronary vessel(s)
027P3ZZ Dilation of Pulmonary Trunk, Percutaneous Approach
027Q3ZZ Dilation of Right Pulmonary Artery, Percutaneous Approach
027R3ZZ Dilation of Left Pulmonary Artery, Percutaneous Approach
027S3ZZ Dilation of Right Pulmonary Vein, Percutaneous Approach
027T3ZZ Dilation of Left Pulmonary Vein, Percutaneous Approach
027V3ZZ Dilation of Superior Vena Cava, Percutaneous Approach
027W3ZZ Dilation of Thoracic Aorta, Percutaneous Approach
03703ZZ Dilation of Right Internal Mammary Artery, Percutaneous Approach
03713ZZ Dilation of Left Internal Mammary Artery, Percutaneous Approach
03723ZZ Dilation of Innominate Artery, Percutaneous Approach
03733ZZ Dilation of Right Subclavian Artery, Percutaneous Approach
03743ZZ Dilation of Left Subclavian Artery, Percutaneous Approach
03753ZZ Dilation of Right Axillary Artery, Percutaneous Approach
03763ZZ Dilation of Left Axillary Artery, Percutaneous Approach
03773ZZ Dilation of Right Brachial Artery, Percutaneous Approach
03783ZZ Dilation of Left Brachial Artery, Percutaneous Approach
03793ZZ Dilation of Right Ulnar Artery, Percutaneous Approach
037A3ZZ Dilation of Left Ulnar Artery, Percutaneous Approach
037B3ZZ Dilation of Right Radial Artery, Percutaneous Approach
037C3ZZ Dilation of Left Radial Artery, Percutaneous Approach
037D3ZZ Dilation of Right Hand Artery, Percutaneous Approach
037F3ZZ Dilation of Left Hand Artery, Percutaneous Approach
037Y3ZZ Dilation of Upper Artery, Percutaneous Approach
04703ZZ Dilation of Abdominal Aorta, Percutaneous Approach
04713ZZ Dilation of Celiac Artery, Percutaneous Approach
04723ZZ Dilation of Gastric Artery, Percutaneous Approach
04733ZZ Dilation of Hepatic Artery, Percutaneous Approach
04743ZZ Dilation of Splenic Artery, Percutaneous Approach
04753ZZ Dilation of Superior Mesenteric Artery, Percutaneous Approach
04763ZZ Dilation of Right Colic Artery, Percutaneous Approach
04773ZZ Dilation of Left Colic Artery, Percutaneous Approach
04783ZZ Dilation of Middle Colic Artery, Percutaneous Approach
04793ZZ Dilation of Right Renal Artery, Percutaneous Approach
047A3ZZ Dilation of Left Renal Artery, Percutaneous Approach
047B3ZZ Dilation of Inferior Mesenteric Artery, Percutaneous Approach
047C3ZZ Dilation of Right Common Iliac Artery, Percutaneous Approach
047D3ZZ Dilation of Left Common Iliac Artery, Percutaneous Approach
047E3ZZ Dilation of Right Internal Iliac Artery, Percutaneous Approach
047F3ZZ Dilation of Left Internal Iliac Artery, Percutaneous Approach
047H3ZZ Dilation of Right External Iliac Artery, Percutaneous Approach
047J3ZZ Dilation of Left External Iliac Artery, Percutaneous Approach
047K3ZZ Dilation of Right Femoral Artery, Percutaneous Approach
047L3ZZ Dilation of Left Femoral Artery, Percutaneous Approach
047M3ZZ Dilation of Right Popliteal Artery, Percutaneous Approach
047N3ZZ Dilation of Left Popliteal Artery, Percutaneous Approach
047P3ZZ Dilation of Right Anterior Tibial Artery, Percutaneous Approach
047Q3ZZ Dilation of Left Anterior Tibial Artery, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 33
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.50
Angioplasty of other
non-coronary vessel(s)
047R3ZZ Dilation of Right Posterior Tibial Artery, Percutaneous Approach
047R3ZZ Dilation of Right Posterior Tibial Artery, Percutaneous Approach
047S3DZ Dilation of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
047T3ZZ Dilation of Right Peroneal Artery, Percutaneous Approach
047U3ZZ Dilation of Left Peroneal Artery, Percutaneous Approach
047V3ZZ Dilation of Right Foot Artery, Percutaneous Approach
047W3ZZ Dilation of Left Foot Artery, Percutaneous Approach
047Y3ZZ Dilation of Lower Artery, Percutaneous Approach
05703ZZ Dilation of Azygos Vein, Percutaneous Approach
05713ZZ Dilation of Hemiazygos Vein, Percutaneous Approach
05733ZZ Dilation of Right Innominate Vein, Percutaneous Approach
05743ZZ Dilation of Left Innominate Vein, Percutaneous Approach
05753ZZ Dilation of Right Subclavian Vein, Percutaneous Approach
05763ZZ Dilation of Left Subclavian Vein, Percutaneous Approach
05773ZZ Dilation of Right Axillary Vein, Percutaneous Approach
05783ZZ Dilation of Left Axillary Vein, Percutaneous Approach
05793ZZ Dilation of Right Brachial Vein, Percutaneous Approach
057A3ZZ Dilation of Left Brachial Vein, Percutaneous Approach
057B3ZZ Dilation of Right Basilic Vein, Percutaneous Approach
057C3ZZ Dilation of Left Basilic Vein, Percutaneous Approach
057D3ZZ Dilation of Right Cephalic Vein, Percutaneous Approach
057F3ZZ Dilation of Left Cephalic Vein, Percutaneous Approach
057G3ZZ Dilation of Right Hand Vein, Percutaneous Approach
057H3ZZ Dilation of Left Hand Vein, Percutaneous Approach
057L3ZZ Dilation of Intracranial Vein, Percutaneous Approach
057M3ZZ Dilation of Right Internal Jugular Vein, Percutaneous Approach
057N3ZZ Dilation of Left Internal Jugular Vein, Percutaneous Approach
057P3ZZ Dilation of Right External Jugular Vein, Percutaneous Approach
057Q3ZZ Dilation of Left External Jugular Vein, Percutaneous Approach
057R3ZZ Dilation of Right Vertebral Vein, Percutaneous Approach
057S3ZZ Dilation of Left Vertebral Vein, Percutaneous Approach
057T3ZZ Dilation of Right Face Vein, Percutaneous Approach
057V3ZZ Dilation of Left Face Vein, Percutaneous Approach
057Y3ZZ Dilation of Upper Vein, Percutaneous Approach
06703ZZ Dilation of Inferior Vena Cava, Percutaneous Approach
06713ZZ Dilation of Splenic Vein, Percutaneous Approach
06723ZZ Dilation of Gastric Vein, Percutaneous Approach
06733ZZ Dilation of Esophageal Vein, Percutaneous Approach
06743ZZ Dilation of Hepatic Vein, Percutaneous Approach
06753ZZ Dilation of Superior Mesenteric Vein, Percutaneous Approach
06763ZZ Dilation of Inferior Mesenteric Vein, Percutaneous Approach
06773ZZ Dilation of Colic Vein, Percutaneous Approach
06783ZZ Dilation of Portal Vein, Percutaneous Approach
06793ZZ Dilation of Right Renal Vein, Percutaneous Approach
067B3ZZ Dilation of Left Renal Vein, Percutaneous Approach
067C3ZZ Dilation of Right Common Iliac Vein, Percutaneous Approach
067D3ZZ Dilation of Left Common Iliac Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 34
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.50
Angioplasty of other
non-coronary vessel(s)
067F3ZZ Dilation of Right External Iliac Vein, Percutaneous Approach
067G3ZZ Dilation of Left External Iliac Vein, Percutaneous Approach
067H3ZZ Dilation of Right Hypogastric Vein, Percutaneous Approach
067J3ZZ Dilation of Left Hypogastric Vein, Percutaneous Approach
067M3ZZ Dilation of Right Femoral Vein, Percutaneous Approach
067N3ZZ Dilation of Left Femoral Vein, Percutaneous Approach
067P3ZZ Dilation of Right Greater Saphenous Vein, Percutaneous Approach
067Q3ZZ Dilation of Left Greater Saphenous Vein, Percutaneous Approach
067R3ZZ Dilation of Right Lesser Saphenous Vein, Percutaneous Approach
067S3ZZ Dilation of Left Lesser Saphenous Vein, Percutaneous Approach
067T3ZZ Dilation of Right Foot Vein, Percutaneous Approach
067V3ZZ Dilation of Left Foot Vein, Percutaneous Approach
067Y3ZZ Dilation of Lower Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 35
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.90
Insertion of non-drug-eluting peripheral (non-coronary) vessel
stent(s)
027P3DZ Dilation of Pulmonary Trunk with Intraluminal Device, Percutaneous Approach
027Q3DZ Dilation of Right Pulmonary Artery with Intraluminal Device, Percutaneous Approach
027R3DZ Dilation of Left Pulmonary Artery with Intraluminal Device, Percutaneous Approach
027S3DZ Dilation of Right Pulmonary Vein with Intraluminal Device, Percutaneous Approach
027T3DZ Dilation of Left Pulmonary Vein with Intraluminal Device, Percutaneous Approach
027V3DZ Dilation of Superior Vena Cava with Intraluminal Device, Percutaneous Approach
027W3DZ Dilation of Thoracic Aorta with Intraluminal Device, Percutaneous Approach
03703DZ Dilation of Right Internal Mammary Artery with Intraluminal Device, Percutaneous Approach
03713DZ Dilation of Left Internal Mammary Artery with Intraluminal Device, Percutaneous Approach
03723DZ Dilation of Innominate Artery with Intraluminal Device, Percutaneous Approach
03733DZ Dilation of Right Subclavian Artery with Intraluminal Device, Percutaneous Approach
03743DZ Dilation of Left Subclavian Artery with Intraluminal Device, Percutaneous Approach
03753DZ Dilation of Right Axillary Artery with Intraluminal Device, Percutaneous Approach
03763DZ Dilation of Left Axillary Artery with Intraluminal Device, Percutaneous Approach
03773DZ Dilation of Right Brachial Artery with Intraluminal Device, Percutaneous Approach
03783DZ Dilation of Left Brachial Artery with Intraluminal Device, Percutaneous Approach
03793DZ Dilation of Right Ulnar Artery with Intraluminal Device, Percutaneous Approach
037A3DZ Dilation of Left Ulnar Artery with Intraluminal Device, Percutaneous Approach
037B3DZ Dilation of Right Radial Artery with Intraluminal Device, Percutaneous Approach
037C3DZ Dilation of Left Radial Artery with Intraluminal Device, Percutaneous Approach
037D3DZ Dilation of Right Hand Artery with Intraluminal Device, Percutaneous Approach
037F3DZ Dilation of Left Hand Artery with Intraluminal Device, Percutaneous Approach
037Y3DZ Dilation of Upper Artery with Intraluminal Device, Percutaneous Approach
04703DZ Dilation of Abdominal Aorta with Intraluminal Device, Percutaneous Approach
04713DZ Dilation of Celiac Artery with Intraluminal Device, Percutaneous Approach
04723DZ Dilation of Gastric Artery with Intraluminal Device, Percutaneous Approach
04733DZ Dilation of Hepatic Artery with Intraluminal Device, Percutaneous Approach
04743DZ Dilation of Splenic Artery with Intraluminal Device, Percutaneous Approach
04753DZ Dilation of Superior Mesenteric Artery with Intraluminal Device, Percutaneous Approach
04763DZ Dilation of Right Colic Artery with Intraluminal Device, Percutaneous Approach
04773DZ Dilation of Left Colic Artery with Intraluminal Device, Percutaneous Approach
04783DZ Dilation of Middle Colic Artery with Intraluminal Device, Percutaneous Approach
04793DZ Dilation of Right Renal Artery with Intraluminal Device, Percutaneous Approach
047A3DZ Dilation of Left Renal Artery with Intraluminal Device, Percutaneous Approach
047B3DZ Dilation of Inferior Mesenteric Artery with Intraluminal Device, Percutaneous Approach
047C3DZ Dilation of Right Common Iliac Artery with Intraluminal Device, Percutaneous Approach
047D3DZ Dilation of Left Common Iliac Artery with Intraluminal Device, Percutaneous Approach
047E3DZ Dilation of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
047F3DZ Dilation of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
047H3DZ Dilation of Right External Iliac Artery with Intraluminal Device, Percutaneous Approach
047J3DZ Dilation of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach
047K3DZ Dilation of Right Femoral Artery with Intraluminal Device, Percutaneous Approach
047L3DZ Dilation of Left Femoral Artery with Intraluminal Device, Percutaneous Approach
047M3DZ Dilation of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach
047N3DZ Dilation of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach
047P3DZ Dilation of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
047Q3DZ Dilation of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 36
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.90
Insertion of non-drug-eluting peripheral (non-coronary) vessel
stent(s)
047R3DZ Dilation of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
047S3DZ Dilation of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
047T3DZ Dilation of Right Peroneal Artery with Intraluminal Device, Percutaneous Approach
047U3DZ Dilation of Left Peroneal Artery with Intraluminal Device, Percutaneous Approach
047V3DZ Dilation of Right Foot Artery with Intraluminal Device, Percutaneous Approach
047W3DZ Dilation of Left Foot Artery with Intraluminal Device, Percutaneous Approach
047Y3DZ Dilation of Lower Artery with Intraluminal Device, Percutaneous Approach
05703DZ Dilation of Azygos Vein with Intraluminal Device, Percutaneous Approach
05713DZ Dilation of Hemiazygos Vein with Intraluminal Device, Percutaneous Approach
05733DZ Dilation of Right Innominate Vein with Intraluminal Device, Percutaneous Approach
05743DZ Dilation of Left Innominate Vein with Intraluminal Device, Percutaneous Approach
05753DZ Dilation of Right Subclavian Vein with Intraluminal Device, Percutaneous Approach
05763DZ Dilation of Left Subclavian Vein with Intraluminal Device, Percutaneous Approach
05773DZ Dilation of Right Axillary Vein with Intraluminal Device, Percutaneous Approach
05783DZ Dilation of Left Axillary Vein with Intraluminal Device, Percutaneous Approach
05793DZ Dilation of Right Brachial Vein with Intraluminal Device, Percutaneous Approach
057A3DZ Dilation of Left Brachial Vein with Intraluminal Device, Percutaneous Approach
057B3DZ Dilation of Right Basilic Vein with Intraluminal Device, Percutaneous Approach
057C3DZ Dilation of Left Basilic Vein with Intraluminal Device, Percutaneous Approach
057D3DZ Dilation of Right Cephalic Vein with Intraluminal Device, Percutaneous Approach
057F3DZ Dilation of Left Cephalic Vein with Intraluminal Device, Percutaneous Approach
057G3DZ Dilation of Right Hand Vein with Intraluminal Device, Percutaneous Approach
057H3DZ Dilation of Left Hand Vein with Intraluminal Device, Percutaneous Approach
057Y4DZ Dilation of Upper Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06703DZ Dilation of Inferior Vena Cava with Intraluminal Device, Percutaneous Approach
06713DZ Dilation of Splenic Vein with Intraluminal Device, Percutaneous Approach
06723DZ Dilation of Gastric Vein with Intraluminal Device, Percutaneous Approach
06733DZ Dilation of Esophageal Vein with Intraluminal Device, Percutaneous Approach
06743DZ Dilation of Hepatic Vein with Intraluminal Device, Percutaneous Approach
06753DZ Dilation of Superior Mesenteric Vein with Intraluminal Device, Percutaneous Approach
06763DZ Dilation of Inferior Mesenteric Vein with Intraluminal Device, Percutaneous Approach
06773DZ Dilation of Colic Vein with Intraluminal Device, Percutaneous Approach
06783DZ Dilation of Portal Vein with Intraluminal Device, Percutaneous Approach
06793DZ Dilation of Right Renal Vein with Intraluminal Device, Percutaneous Approach
067B3DZ Dilation of Left Renal Vein with Intraluminal Device, Percutaneous Approach
067C3DZ Dilation of Right Common Iliac Vein with Intraluminal Device, Percutaneous Approach
067D3DZ Dilation of Left Common Iliac Vein with Intraluminal Device, Percutaneous Approach
067F3DZ Dilation of Right External Iliac Vein with Intraluminal Device, Percutaneous Approach
067G3DZ Dilation of Left External Iliac Vein with Intraluminal Device, Percutaneous Approach
067H3DZ Dilation of Right Hypogastric Vein with Intraluminal Device, Percutaneous Approach
067J3DZ Dilation of Left Hypogastric Vein with Intraluminal Device, Percutaneous Approach
067M3DZ Dilation of Right Femoral Vein with Intraluminal Device, Percutaneous Approach
067N3DZ Dilation of Left Femoral Vein with Intraluminal Device, Percutaneous Approach
067P3DZ Dilation of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
067Q3DZ Dilation of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
067R3DZ Dilation of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
067S3DZ Dilation of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 37
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.90
Insertion of non-drug-eluting peripheral (non-coronary) vessel
stent(s)
067T3DZ Dilation of Right Foot Vein with Intraluminal Device, Percutaneous Approach
067V3DZ Dilation of Left Foot Vein with Intraluminal Device, Percutaneous Approach
067Y3DZ Dilation of Lower Vein with Intraluminal Device, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 38
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
02LS3DZ Occlusion of Right Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02LS3ZZ Occlusion of Right Pulmonary Vein, Percutaneous Approach
02LT3DZ Occlusion of Left Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02LT3ZZ Occlusion of Left Pulmonary Vein, Percutaneous Approach
02VP3DZ Restriction of Pulmonary Trunk with Intraluminal Device, Percutaneous Approach
02VP3ZZ Restriction of Pulmonary Trunk, Percutaneous Approach
02VQ3DZ Restriction of Right Pulmonary Artery with Intraluminal Device, Percutaneous Approach
02VQ3ZZ Restriction of Right Pulmonary Artery, Percutaneous Approach
02VR3DT Restriction of Ductus Arteriosus with Intraluminal Device, Percutaneous Approach
02VR3DZ Restriction of Left Pulmonary Artery with Intraluminal Device, Percutaneous Approach
02VR3ZT Restriction of Ductus Arteriosus, Percutaneous Approach
02VR3ZZ Restriction of Left Pulmonary Artery, Percutaneous Approach
02VS3DZ Restriction of Right Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02VS3ZZ Restriction of Right Pulmonary Vein, Percutaneous Approach
02VT3DZ Restriction of Left Pulmonary Vein with Intraluminal Device, Percutaneous Approach
02VT3ZZ Restriction of Left Pulmonary Vein, Percutaneous Approach
02VW3DZ Restriction of Thoracic Aorta with Intraluminal Device, Percutaneous Approach
02VW3ZZ Restriction of Thoracic Aorta, Percutaneous Approach
03L03ZZ Occlusion of Right Internal Mammary Artery, Percutaneous Approach
03L13ZZ Occlusion of Left Internal Mammary Artery, Percutaneous Approach
03L23ZZ Occlusion of Innominate Artery, Percutaneous Approach
03L33ZZ Occlusion of Right Subclavian Artery, Percutaneous Approach
03L43ZZ Occlusion of Left Subclavian Artery, Percutaneous Approach
03L50DZ Occlusion of Right Axillary Artery with Intraluminal Device, Open Approach
03L53DZ Occlusion of Right Axillary Artery with Intraluminal Device, Percutaneous Approach
03L53ZZ Occlusion of Right Axillary Artery, Percutaneous Approach
03L54DZ Occlusion of Right Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L60DZ Occlusion of Left Axillary Artery with Intraluminal Device, Open Approach
03L63DZ Occlusion of Left Axillary Artery with Intraluminal Device, Percutaneous Approach
03L63ZZ Occlusion of Left Axillary Artery, Percutaneous Approach
03L64DZ Occlusion of Left Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L70DZ Occlusion of Right Brachial Artery with Intraluminal Device, Open Approach
03L73DZ Occlusion of Right Brachial Artery with Intraluminal Device, Percutaneous Approach
03L73ZZ Occlusion of Right Brachial Artery, Percutaneous Approach
03L74DZ Occlusion of Right Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L80DZ Occlusion of Left Brachial Artery with Intraluminal Device, Open Approach
03L83DZ Occlusion of Left Brachial Artery with Intraluminal Device, Percutaneous Approach
03L83ZZ Occlusion of Left Brachial Artery, Percutaneous Approach
03L84DZ Occlusion of Left Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03L90DZ Occlusion of Right Ulnar Artery with Intraluminal Device, Open Approach
03L93DZ Occlusion of Right Ulnar Artery with Intraluminal Device, Percutaneous Approach
03L93ZZ Occlusion of Right Ulnar Artery, Percutaneous Approach
03L94DZ Occlusion of Right Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LA0DZ Occlusion of Left Ulnar Artery with Intraluminal Device, Open Approach
03LA3DZ Occlusion of Left Ulnar Artery with Intraluminal Device, Percutaneous Approach
03LA3ZZ Occlusion of Left Ulnar Artery, Percutaneous Approach
03LA4DZ Occlusion of Left Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 39
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03LB0DZ Occlusion of Right Radial Artery with Intraluminal Device, Open Approach
03LB3DZ Occlusion of Right Radial Artery with Intraluminal Device, Percutaneous Approach
03LB3ZZ Occlusion of Right Radial Artery, Percutaneous Approach
03LB4DZ Occlusion of Right Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LC0DZ Occlusion of Left Radial Artery with Intraluminal Device, Open Approach
03LC3DZ Occlusion of Left Radial Artery with Intraluminal Device, Percutaneous Approach
03LC3ZZ Occlusion of Left Radial Artery, Percutaneous Approach
03LC4DZ Occlusion of Left Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LD0DZ Occlusion of Right Hand Artery with Intraluminal Device, Open Approach
03LD3DZ Occlusion of Right Hand Artery with Intraluminal Device, Percutaneous Approach
03LD3ZZ Occlusion of Right Hand Artery, Percutaneous Approach
03LD4DZ Occlusion of Right Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LF0DZ Occlusion of Left Hand Artery with Intraluminal Device, Open Approach
03LF3DZ Occlusion of Left Hand Artery with Intraluminal Device, Percutaneous Approach
03LF3ZZ Occlusion of Left Hand Artery, Percutaneous Approach
03LF4DZ Occlusion of Left Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03LG3ZZ Occlusion of Intracranial Artery, Percutaneous Approach
03LH3ZZ Occlusion of Right Common Carotid Artery, Percutaneous Approach
03LJ3ZZ Occlusion of Left Common Carotid Artery, Percutaneous Approach
03LK3ZZ Occlusion of Right Internal Carotid Artery, Percutaneous Approach
03LL3ZZ Occlusion of Left Internal Carotid Artery, Percutaneous Approach
03LM3ZZ Occlusion of Right External Carotid Artery, Percutaneous Approach
03LN3ZZ Occlusion of Left External Carotid Artery, Percutaneous Approach
03LP3ZZ Occlusion of Right Vertebral Artery, Percutaneous Approach
03LQ3ZZ Occlusion of Left Vertebral Artery, Percutaneous Approach
03LR3ZZ Occlusion of Face Artery, Percutaneous Approach
03LS3ZZ Occlusion of Right Temporal Artery, Percutaneous Approach
03LT3ZZ Occlusion of Left Temporal Artery, Percutaneous Approach
03LU3ZZ Occlusion of Right Thyroid Artery, Percutaneous Approach
03LV3ZZ Occlusion of Left Thyroid Artery, Percutaneous Approach
03LY0DZ Occlusion of Upper Artery with Intraluminal Device, Open Approach
03LY3DZ Occlusion of Upper Artery with Intraluminal Device, Percutaneous Approach
03LY3ZZ Occlusion of Upper Artery, Percutaneous Approach
03LY4DZ Occlusion of Upper Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V00DZ Restriction of Right Internal Mammary Artery with Intraluminal Device, Open Approach
03V03DZ Restriction of Right Internal Mammary Artery with Intraluminal Device, Percutaneous Approach
03V03ZZ Restriction of Right Internal Mammary Artery, Percutaneous Approach
03V04DZ Restriction of Right Internal Mammary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V10DZ Restriction of Left Internal Mammary Artery with Intraluminal Device, Open Approach
03V13DZ Restriction of Left Internal Mammary Artery with Intraluminal Device, Percutaneous Approach
03V13ZZ Restriction of Left Internal Mammary Artery, Percutaneous Approach
03V14DZ Restriction of Left Internal Mammary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V20DZ Restriction of Innominate Artery with Intraluminal Device, Open Approach
03V23DZ Restriction of Innominate Artery with Intraluminal Device, Percutaneous Approach
03V23ZZ Restriction of Innominate Artery, Percutaneous Approach
03V24DZ Restriction of Innominate Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V30DZ Restriction of Right Subclavian Artery with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 40
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03V33DZ Restriction of Right Subclavian Artery with Intraluminal Device, Percutaneous Approach
03V33ZZ Restriction of Right Subclavian Artery, Percutaneous Approach
03V34DZ Restriction of Right Subclavian Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V40DZ Restriction of Left Subclavian Artery with Intraluminal Device, Open Approach
03V43DZ Restriction of Left Subclavian Artery with Intraluminal Device, Percutaneous Approach
03V43ZZ Restriction of Left Subclavian Artery, Percutaneous Approach
03V44DZ Restriction of Left Subclavian Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V50DZ Restriction of Right Axillary Artery with Intraluminal Device, Open Approach
03V53DZ Restriction of Right Axillary Artery with Intraluminal Device, Percutaneous Approach
03V53ZZ Restriction of Right Axillary Artery, Percutaneous Approach
03V54DZ Restriction of Right Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V60DZ Restriction of Left Axillary Artery with Intraluminal Device, Open Approach
03V63DZ Restriction of Left Axillary Artery with Intraluminal Device, Percutaneous Approach
03V63ZZ Restriction of Left Axillary Artery, Percutaneous Approach
03V64DZ Restriction of Left Axillary Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V70DZ Restriction of Right Brachial Artery with Intraluminal Device, Open Approach
03V73DZ Restriction of Right Brachial Artery with Intraluminal Device, Percutaneous Approach
03V73ZZ Restriction of Right Brachial Artery, Percutaneous Approach
03V74DZ Restriction of Right Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V80DZ Restriction of Left Brachial Artery with Intraluminal Device, Open Approach
03V83DZ Restriction of Left Brachial Artery with Intraluminal Device, Percutaneous Approach
03V83ZZ Restriction of Left Brachial Artery, Percutaneous Approach
03V84DZ Restriction of Left Brachial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03V90DZ Restriction of Right Ulnar Artery with Intraluminal Device, Open Approach
03V93DZ Restriction of Right Ulnar Artery with Intraluminal Device, Percutaneous Approach
03V93ZZ Restriction of Right Ulnar Artery, Percutaneous Approach
03V94DZ Restriction of Right Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VA0DZ Restriction of Left Ulnar Artery with Intraluminal Device, Open Approach
03VA3DZ Restriction of Left Ulnar Artery with Intraluminal Device, Percutaneous Approach
03VA3ZZ Restriction of Left Ulnar Artery, Percutaneous Approach
03VA4DZ Restriction of Left Ulnar Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VB0DZ Restriction of Right Radial Artery with Intraluminal Device, Open Approach
03VB3DZ Restriction of Right Radial Artery with Intraluminal Device, Percutaneous Approach
03VB3ZZ Restriction of Right Radial Artery, Percutaneous Approach
03VB4DZ Restriction of Right Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VC0DZ Restriction of Left Radial Artery with Intraluminal Device, Open Approach
03VC3DZ Restriction of Left Radial Artery with Intraluminal Device, Percutaneous Approach
03VC3ZZ Restriction of Left Radial Artery, Percutaneous Approach
03VC4DZ Restriction of Left Radial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VD0DZ Restriction of Right Hand Artery with Intraluminal Device, Open Approach
03VD3DZ Restriction of Right Hand Artery with Intraluminal Device, Percutaneous Approach
03VD3ZZ Restriction of Right Hand Artery, Percutaneous Approach
03VD4DZ Restriction of Right Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
03VF0DZ Restriction of Left Hand Artery with Intraluminal Device, Open Approach
03VF3DZ Restriction of Left Hand Artery with Intraluminal Device, Percutaneous Approach
03VF3ZZ Restriction of Left Hand Artery, Percutaneous Approach
03VF4DZ Restriction of Left Hand Artery with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 41
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03VG3ZZ Restriction of Intracranial Artery, Percutaneous Approach
03VH3ZZ Restriction of Right Common Carotid Artery, Percutaneous Approach
03VJ3ZZ Restriction of Left Common Carotid Artery, Percutaneous Approach
03VK3ZZ Restriction of Right Internal Carotid Artery, Percutaneous Approach
03VL3ZZ Restriction of Left Internal Carotid Artery, Percutaneous Approach
03VM3ZZ Restriction of Right External Carotid Artery, Percutaneous Approach
03VN3ZZ Restriction of Left External Carotid Artery, Percutaneous Approach
03VP3ZZ Restriction of Right Vertebral Artery, Percutaneous Approach
03VQ3ZZ Restriction of Left Vertebral Artery, Percutaneous Approach
03VR3ZZ Restriction of Face Artery, Percutaneous Approach
03VS3ZZ Restriction of Right Temporal Artery, Percutaneous Approach
03VT3ZZ Restriction of Left Temporal Artery, Percutaneous Approach
03VU3ZZ Restriction of Right Thyroid Artery, Percutaneous Approach
03VV3ZZ Restriction of Left Thyroid Artery, Percutaneous Approach
03VY0DZ Restriction of Upper Artery with Intraluminal Device, Open Approach
03VY3DZ Restriction of Upper Artery with Intraluminal Device, Percutaneous Approach
03VY3ZZ Restriction of Upper Artery, Percutaneous Approach
03VY4DZ Restriction of Upper Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04L03ZZ Occlusion of Abdominal Aorta, Percutaneous Approach
04L13ZZ Occlusion of Celiac Artery, Percutaneous Approach
04L23ZZ Occlusion of Gastric Artery, Percutaneous Approach
04L33ZZ Occlusion of Hepatic Artery, Percutaneous Approach
04L43ZZ Occlusion of Splenic Artery, Percutaneous Approach
04L53ZZ Occlusion of Superior Mesenteric Artery, Percutaneous Approach
04L63ZZ Occlusion of Right Colic Artery, Percutaneous Approach
04L73ZZ Occlusion of Left Colic Artery, Percutaneous Approach
04L83ZZ Occlusion of Middle Colic Artery, Percutaneous Approach
04L93ZZ Occlusion of Right Renal Artery, Percutaneous Approach
04LA3ZZ Occlusion of Left Renal Artery, Percutaneous Approach
04LB3ZZ Occlusion of Inferior Mesenteric Artery, Percutaneous Approach
04LC0DZ Occlusion of Right Common Iliac Artery with Intraluminal Device, Open Approach
04LC3DZ Occlusion of Right Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04LC3ZZ Occlusion of Right Common Iliac Artery, Percutaneous Approach
04LC4DZ Occlusion of Right Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LD0DZ Occlusion of Left Common Iliac Artery with Intraluminal Device, Open Approach
04LD3DZ Occlusion of Left Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04LD3ZZ Occlusion of Left Common Iliac Artery, Percutaneous Approach
04LD4DZ Occlusion of Left Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LE0DZ Occlusion of Right Internal Iliac Artery with Intraluminal Device, Open Approach
04LE3DZ Occlusion of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04LE3ZZ Occlusion of Right Internal Iliac Artery, Percutaneous Approach
04LE4DZ Occlusion of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LF0DZ Occlusion of Left Internal Iliac Artery with Intraluminal Device, Open Approach
04LF3DZ Occlusion of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04LF3ZZ Occlusion of Left Internal Iliac Artery, Percutaneous Approach
04LF4DZ Occlusion of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LH0DZ Occlusion of Right External Iliac Artery with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 42
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04LH3DZ Occlusion of Right External Iliac Artery with Intraluminal Device, Percutaneous Approach
04LH3ZZ Occlusion of Right External Iliac Artery, Percutaneous Approach
04LH4DZ Occlusion of Right External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LJ0DZ Occlusion of Left External Iliac Artery with Intraluminal Device, Open Approach
04LJ3DZ Occlusion of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach
04LJ3ZZ Occlusion of Left External Iliac Artery, Percutaneous Approach
04LJ4DZ Occlusion of Left External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LK0DZ Occlusion of Right Femoral Artery with Intraluminal Device, Open Approach
04LK3DZ Occlusion of Right Femoral Artery with Intraluminal Device, Percutaneous Approach
04LK3ZZ Occlusion of Right Femoral Artery, Percutaneous Approach
04LK4DZ Occlusion of Right Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LL0DZ Occlusion of Left Femoral Artery with Intraluminal Device, Open Approach
04LL3DZ Occlusion of Left Femoral Artery with Intraluminal Device, Percutaneous Approach
04LL3ZZ Occlusion of Left Femoral Artery, Percutaneous Approach
04LL4DZ Occlusion of Left Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LM0DZ Occlusion of Right Popliteal Artery with Intraluminal Device, Open Approach
04LM3DZ Occlusion of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach
04LM3ZZ Occlusion of Right Popliteal Artery, Percutaneous Approach
04LM4DZ Occlusion of Right Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LN0DZ Occlusion of Left Popliteal Artery with Intraluminal Device, Open Approach
04LN3DZ Occlusion of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach
04LN3ZZ Occlusion of Left Popliteal Artery, Percutaneous Approach
04LN4DZ Occlusion of Left Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LP0DZ Occlusion of Right Anterior Tibial Artery with Intraluminal Device, Open Approach
04LP3DZ Occlusion of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LP3ZZ Occlusion of Right Anterior Tibial Artery, Percutaneous Approach
04LP4DZ Occlusion of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LQ0DZ Occlusion of Left Anterior Tibial Artery with Intraluminal Device, Open Approach
04LQ3DZ Occlusion of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LQ3ZZ Occlusion of Left Anterior Tibial Artery, Percutaneous Approach
04LQ4DZ Occlusion of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LR0DZ Occlusion of Right Posterior Tibial Artery with Intraluminal Device, Open Approach
04LR3DZ Occlusion of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LR3ZZ Occlusion of Right Posterior Tibial Artery, Percutaneous Approach
04LR4DZ Occlusion of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LS0DZ Occlusion of Left Posterior Tibial Artery with Intraluminal Device, Open Approach
04LS3DZ Occlusion of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04LS3ZZ Occlusion of Left Posterior Tibial Artery, Percutaneous Approach
04LS4DZ Occlusion of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LT0DZ Occlusion of Right Peroneal Artery with Intraluminal Device, Open Approach
04LT3DZ Occlusion of Right Peroneal Artery with Intraluminal Device, Percutaneous Approach
04LT3ZZ Occlusion of Right Peroneal Artery, Percutaneous Approach
04LT4DZ Occlusion of Right Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LU0DZ Occlusion of Left Peroneal Artery with Intraluminal Device, Open Approach
04LU3DZ Occlusion of Left Peroneal Artery with Intraluminal Device, Percutaneous Approach
04LU3ZZ Occlusion of Left Peroneal Artery, Percutaneous Approach
04LU4DZ Occlusion of Left Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 43
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04LV0DZ Occlusion of Right Foot Artery with Intraluminal Device, Open Approach
04LV3DZ Occlusion of Right Foot Artery with Intraluminal Device, Percutaneous Approach
04LV3ZZ Occlusion of Right Foot Artery, Percutaneous Approach
04LV4DZ Occlusion of Right Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LW0DZ Occlusion of Left Foot Artery with Intraluminal Device, Open Approach
04LW3DZ Occlusion of Left Foot Artery with Intraluminal Device, Percutaneous Approach
04LW3ZZ Occlusion of Left Foot Artery, Percutaneous Approach
04LW4DZ Occlusion of Left Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04LY0DZ Occlusion of Lower Artery with Intraluminal Device, Open Approach
04LY3DZ Occlusion of Lower Artery with Intraluminal Device, Percutaneous Approach
04LY3ZZ Occlusion of Lower Artery, Percutaneous Approach
04LY4DZ Occlusion of Lower Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V03ZZ Restriction of Abdominal Aorta, Percutaneous Approach
04V10DZ Restriction of Celiac Artery with Intraluminal Device, Open Approach
04V13DZ Restriction of Celiac Artery with Intraluminal Device, Percutaneous Approach
04V13ZZ Restriction of Celiac Artery, Percutaneous Approach
04V14DZ Restriction of Celiac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V20DZ Restriction of Gastric Artery with Intraluminal Device, Open Approach
04V23DZ Restriction of Gastric Artery with Intraluminal Device, Percutaneous Approach
04V23ZZ Restriction of Gastric Artery, Percutaneous Approach
04V24DZ Restriction of Gastric Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V30DZ Restriction of Hepatic Artery with Intraluminal Device, Open Approach
04V33DZ Restriction of Hepatic Artery with Intraluminal Device, Percutaneous Approach
04V33ZZ Restriction of Hepatic Artery, Percutaneous Approach
04V34DZ Restriction of Hepatic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V40DZ Restriction of Splenic Artery with Intraluminal Device, Open Approach
04V43DZ Restriction of Splenic Artery with Intraluminal Device, Percutaneous Approach
04V43ZZ Restriction of Splenic Artery, Percutaneous Approach
04V44DZ Restriction of Splenic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V50DZ Restriction of Superior Mesenteric Artery with Intraluminal Device, Open Approach
04V53DZ Restriction of Superior Mesenteric Artery with Intraluminal Device, Percutaneous Approach
04V53ZZ Restriction of Superior Mesenteric Artery, Percutaneous Approach
04V54DZ Restriction of Superior Mesenteric Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V60DZ Restriction of Right Colic Artery with Intraluminal Device, Open Approach
04V63DZ Restriction of Right Colic Artery with Intraluminal Device, Percutaneous Approach
04V63ZZ Restriction of Right Colic Artery, Percutaneous Approach
04V64DZ Restriction of Right Colic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V70DZ Restriction of Left Colic Artery with Intraluminal Device, Open Approach
04V73DZ Restriction of Left Colic Artery with Intraluminal Device, Percutaneous Approach
04V73ZZ Restriction of Left Colic Artery, Percutaneous Approach
04V74DZ Restriction of Left Colic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V80DZ Restriction of Middle Colic Artery with Intraluminal Device, Open Approach
04V83DZ Restriction of Middle Colic Artery with Intraluminal Device, Percutaneous Approach
04V83ZZ Restriction of Middle Colic Artery, Percutaneous Approach
04V84DZ Restriction of Middle Colic Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04V90DZ Restriction of Right Renal Artery with Intraluminal Device, Open Approach
04V93DZ Restriction of Right Renal Artery with Intraluminal Device, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 44
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04V93ZZ Restriction of Right Renal Artery, Percutaneous Approach
04V94DZ Restriction of Right Renal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VA0DZ Restriction of Left Renal Artery with Intraluminal Device, Open Approach
04VA3DZ Restriction of Left Renal Artery with Intraluminal Device, Percutaneous Approach
04VA3ZZ Restriction of Left Renal Artery, Percutaneous Approach
04VA4DZ Restriction of Left Renal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VB0DZ Restriction of Inferior Mesenteric Artery with Intraluminal Device, Open Approach
04VB3DZ Restriction of Inferior Mesenteric Artery with Intraluminal Device, Percutaneous Approach
04VB3ZZ Restriction of Inferior Mesenteric Artery, Percutaneous Approach
04VB4DZ Restriction of Inferior Mesenteric Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VC0DZ Restriction of Right Common Iliac Artery with Intraluminal Device, Open Approach
04VC3DZ Restriction of Right Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04VC3ZZ Restriction of Right Common Iliac Artery, Percutaneous Approach
04VC4DZ Restriction of Right Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VD0DZ Restriction of Left Common Iliac Artery with Intraluminal Device, Open Approach
04VD3DZ Restriction of Left Common Iliac Artery with Intraluminal Device, Percutaneous Approach
04VD3ZZ Restriction of Left Common Iliac Artery, Percutaneous Approach
04VD4DZ Restriction of Left Common Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VE0DZ Restriction of Right Internal Iliac Artery with Intraluminal Device, Open Approach
04VE3DZ Restriction of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04VE3ZZ Restriction of Right Internal Iliac Artery, Percutaneous Approach
04VE4DZ Restriction of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VF0DZ Restriction of Left Internal Iliac Artery with Intraluminal Device, Open Approach
04VF3DZ Restriction of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Approach
04VF3ZZ Restriction of Left Internal Iliac Artery, Percutaneous Approach
04VF4DZ Restriction of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VH0DZ Restriction of Right External Iliac Artery with Intraluminal Device, Open Approach
04VH3DZ Restriction of Right External Iliac Artery with Intraluminal Device, Percutaneous Approach
04VH3ZZ Restriction of Right External Iliac Artery, Percutaneous Approach
04VH4DZ Restriction of Right External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VJ0DZ Restriction of Left External Iliac Artery with Intraluminal Device, Open Approach
04VJ3DZ Restriction of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach
04VJ3ZZ Restriction of Left External Iliac Artery, Percutaneous Approach
04VJ4DZ Restriction of Left External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VK0DZ Restriction of Right Femoral Artery with Intraluminal Device, Open Approach
04VK3DZ Restriction of Right Femoral Artery with Intraluminal Device, Percutaneous Approach
04VK3ZZ Restriction of Right Femoral Artery, Percutaneous Approach
04VK4DZ Restriction of Right Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VL0DZ Restriction of Left Femoral Artery with Intraluminal Device, Open Approach
04VL3DZ Restriction of Left Femoral Artery with Intraluminal Device, Percutaneous Approach
04VL3ZZ Restriction of Left Femoral Artery, Percutaneous Approach
04VL4DZ Restriction of Left Femoral Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VM0DZ Restriction of Right Popliteal Artery with Intraluminal Device, Open Approach
04VM3DZ Restriction of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach
04VM3ZZ Restriction of Right Popliteal Artery, Percutaneous Approach
04VM4DZ Restriction of Right Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VN0DZ Restriction of Left Popliteal Artery with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 45
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
04VN3DZ Restriction of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach
04VN3ZZ Restriction of Left Popliteal Artery, Percutaneous Approach
04VN4DZ Restriction of Left Popliteal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VP0DZ Restriction of Right Anterior Tibial Artery with Intraluminal Device, Open Approach
04VP3DZ Restriction of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VP3ZZ Restriction of Right Anterior Tibial Artery, Percutaneous Approach
04VP4DZ Restriction of Right Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VQ0DZ Restriction of Left Anterior Tibial Artery with Intraluminal Device, Open Approach
04VQ3DZ Restriction of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VQ3ZZ Restriction of Left Anterior Tibial Artery, Percutaneous Approach
04VQ4DZ Restriction of Left Anterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VR0DZ Restriction of Right Posterior Tibial Artery with Intraluminal Device, Open Approach
04VR3DZ Restriction of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VR3ZZ Restriction of Right Posterior Tibial Artery, Percutaneous Approach
04VR4DZ Restriction of Right Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VS0DZ Restriction of Left Posterior Tibial Artery with Intraluminal Device, Open Approach
04VS3DZ Restriction of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Approach
04VS3ZZ Restriction of Left Posterior Tibial Artery, Percutaneous Approach
04VS4DZ Restriction of Left Posterior Tibial Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VT0DZ Restriction of Right Peroneal Artery with Intraluminal Device, Open Approach
04VT3DZ Restriction of Right Peroneal Artery with Intraluminal Device, Percutaneous Approach
04VT3ZZ Restriction of Right Peroneal Artery, Percutaneous Approach
04VT4DZ Restriction of Right Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VU0DZ Restriction of Left Peroneal Artery with Intraluminal Device, Open Approach
04VU3DZ Restriction of Left Peroneal Artery with Intraluminal Device, Percutaneous Approach
04VU3ZZ Restriction of Left Peroneal Artery, Percutaneous Approach
04VU4DZ Restriction of Left Peroneal Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VV0DZ Restriction of Right Foot Artery with Intraluminal Device, Open Approach
04VV3DZ Restriction of Right Foot Artery with Intraluminal Device, Percutaneous Approach
04VV3ZZ Restriction of Right Foot Artery, Percutaneous Approach
04VV4DZ Restriction of Right Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VW0DZ Restriction of Left Foot Artery with Intraluminal Device, Open Approach
04VW3DZ Restriction of Left Foot Artery with Intraluminal Device, Percutaneous Approach
04VW3ZZ Restriction of Left Foot Artery, Percutaneous Approach
04VW4DZ Restriction of Left Foot Artery with Intraluminal Device, Percutaneous Endoscopic Approach
04VY0DZ Restriction of Lower Artery with Intraluminal Device, Open Approach
04VY3DZ Restriction of Lower Artery with Intraluminal Device, Percutaneous Approach
04VY3ZZ Restriction of Lower Artery, Percutaneous Approach
04VY4DZ Restriction of Lower Artery with Intraluminal Device, Percutaneous Endoscopic Approach
05L03ZZ Occlusion of Azygos Vein, Percutaneous Approach
05L13ZZ Occlusion of Hemiazygos Vein, Percutaneous Approach
05L33ZZ Occlusion of Right Innominate Vein, Percutaneous Approach
05L43ZZ Occlusion of Left Innominate Vein, Percutaneous Approach
05L53ZZ Occlusion of Right Subclavian Vein, Percutaneous Approach
05L63ZZ Occlusion of Left Subclavian Vein, Percutaneous Approach
05L70DZ Occlusion of Right Axillary Vein with Intraluminal Device, Open Approach
05L73DZ Occlusion of Right Axillary Vein with Intraluminal Device, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 46
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05L73ZZ Occlusion of Right Axillary Vein, Percutaneous Approach
05L74DZ Occlusion of Right Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05L80DZ Occlusion of Left Axillary Vein with Intraluminal Device, Open Approach
05L83DZ Occlusion of Left Axillary Vein with Intraluminal Device, Percutaneous Approach
05L83ZZ Occlusion of Left Axillary Vein, Percutaneous Approach
05L84DZ Occlusion of Left Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05L90DZ Occlusion of Right Brachial Vein with Intraluminal Device, Open Approach
05L93DZ Occlusion of Right Brachial Vein with Intraluminal Device, Percutaneous Approach
05L93ZZ Occlusion of Right Brachial Vein, Percutaneous Approach
05L94DZ Occlusion of Right Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LA0DZ Occlusion of Left Brachial Vein with Intraluminal Device, Open Approach
05LA3DZ Occlusion of Left Brachial Vein with Intraluminal Device, Percutaneous Approach
05LA3ZZ Occlusion of Left Brachial Vein, Percutaneous Approach
05LA4DZ Occlusion of Left Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LB0DZ Occlusion of Right Basilic Vein with Intraluminal Device, Open Approach
05LB3DZ Occlusion of Right Basilic Vein with Intraluminal Device, Percutaneous Approach
05LB3ZZ Occlusion of Right Basilic Vein, Percutaneous Approach
05LB4DZ Occlusion of Right Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LC0DZ Occlusion of Left Basilic Vein with Intraluminal Device, Open Approach
05LC3DZ Occlusion of Left Basilic Vein with Intraluminal Device, Percutaneous Approach
05LC3ZZ Occlusion of Left Basilic Vein, Percutaneous Approach
05LC4DZ Occlusion of Left Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LD0DZ Occlusion of Right Cephalic Vein with Intraluminal Device, Open Approach
05LD3DZ Occlusion of Right Cephalic Vein with Intraluminal Device, Percutaneous Approach
05LD3ZZ Occlusion of Right Cephalic Vein, Percutaneous Approach
05LD4DZ Occlusion of Right Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LF0DZ Occlusion of Left Cephalic Vein with Intraluminal Device, Open Approach
05LF3DZ Occlusion of Left Cephalic Vein with Intraluminal Device, Percutaneous Approach
05LF3ZZ Occlusion of Left Cephalic Vein, Percutaneous Approach
05LF4DZ Occlusion of Left Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LG0DZ Occlusion of Right Hand Vein with Intraluminal Device, Open Approach
05LG3DZ Occlusion of Right Hand Vein with Intraluminal Device, Percutaneous Approach
05LG3ZZ Occlusion of Right Hand Vein, Percutaneous Approach
05LG4DZ Occlusion of Right Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LH0DZ Occlusion of Left Hand Vein with Intraluminal Device, Open Approach
05LH3DZ Occlusion of Left Hand Vein with Intraluminal Device, Percutaneous Approach
05LH3ZZ Occlusion of Left Hand Vein, Percutaneous Approach
05LH4DZ Occlusion of Left Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05LL3ZZ Occlusion of Intracranial Vein, Percutaneous Approach
05LM3ZZ Occlusion of Right Internal Jugular Vein, Percutaneous Approach
05LN3ZZ Occlusion of Left Internal Jugular Vein, Percutaneous Approach
05LP3ZZ Occlusion of Right External Jugular Vein, Percutaneous Approach
05LQ3ZZ Occlusion of Left External Jugular Vein, Percutaneous Approach
05LR3ZZ Occlusion of Right Vertebral Vein, Percutaneous Approach
05LS3ZZ Occlusion of Left Vertebral Vein, Percutaneous Approach
05LT3ZZ Occlusion of Right Face Vein, Percutaneous Approach
05LV3ZZ Occlusion of Left Face Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 47
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05LY0DZ Occlusion of Upper Vein with Intraluminal Device, Open Approach
05LY3ZZ Occlusion of Upper Vein, Percutaneous Approach
05V00DZ Restriction of Azygos Vein with Intraluminal Device, Open Approach
05V03DZ Restriction of Azygos Vein with Intraluminal Device, Percutaneous Approach
05V03ZZ Restriction of Azygos Vein, Percutaneous Approach
05V04DZ Restriction of Azygos Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V10DZ Restriction of Hemiazygos Vein with Intraluminal Device, Open Approach
05V13DZ Restriction of Hemiazygos Vein with Intraluminal Device, Percutaneous Approach
05V13ZZ Restriction of Hemiazygos Vein, Percutaneous Approach
05V14DZ Restriction of Hemiazygos Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V30DZ Restriction of Right Innominate Vein with Intraluminal Device, Open Approach
05V33DZ Restriction of Right Innominate Vein with Intraluminal Device, Percutaneous Approach
05V33ZZ Restriction of Right Innominate Vein, Percutaneous Approach
05V34DZ Restriction of Right Innominate Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V40DZ Restriction of Left Innominate Vein with Intraluminal Device, Open Approach
05V43DZ Restriction of Left Innominate Vein with Intraluminal Device, Percutaneous Approach
05V43ZZ Restriction of Left Innominate Vein, Percutaneous Approach
05V44DZ Restriction of Left Innominate Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V50DZ Restriction of Right Subclavian Vein with Intraluminal Device, Open Approach
05V53DZ Restriction of Right Subclavian Vein with Intraluminal Device, Percutaneous Approach
05V53ZZ Restriction of Right Subclavian Vein, Percutaneous Approach
05V54DZ Restriction of Right Subclavian Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V60DZ Restriction of Left Subclavian Vein with Intraluminal Device, Open Approach
05V63DZ Restriction of Left Subclavian Vein with Intraluminal Device, Percutaneous Approach
05V63ZZ Restriction of Left Subclavian Vein, Percutaneous Approach
05V64DZ Restriction of Left Subclavian Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V70DZ Restriction of Right Axillary Vein with Intraluminal Device, Open Approach
05V73DZ Restriction of Right Axillary Vein with Intraluminal Device, Percutaneous Approach
05V73ZZ Restriction of Right Axillary Vein, Percutaneous Approach
05V74DZ Restriction of Right Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V80DZ Restriction of Left Axillary Vein with Intraluminal Device, Open Approach
05V83DZ Restriction of Left Axillary Vein with Intraluminal Device, Percutaneous Approach
05V83ZZ Restriction of Left Axillary Vein, Percutaneous Approach
05V84DZ Restriction of Left Axillary Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05V90DZ Restriction of Right Brachial Vein with Intraluminal Device, Open Approach
05V93DZ Restriction of Right Brachial Vein with Intraluminal Device, Percutaneous Approach
05V93ZZ Restriction of Right Brachial Vein, Percutaneous Approach
05V94DZ Restriction of Right Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VA0DZ Restriction of Left Brachial Vein with Intraluminal Device, Open Approach
05VA3DZ Restriction of Left Brachial Vein with Intraluminal Device, Percutaneous Approach
05VA3ZZ Restriction of Left Brachial Vein, Percutaneous Approach
05VA4DZ Restriction of Left Brachial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VB0DZ Restriction of Right Basilic Vein with Intraluminal Device, Open Approach
05VB3DZ Restriction of Right Basilic Vein with Intraluminal Device, Percutaneous Approach
05VB3ZZ Restriction of Right Basilic Vein, Percutaneous Approach
05VB4DZ Restriction of Right Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VC0DZ Restriction of Left Basilic Vein with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 48
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05VC3DZ Restriction of Left Basilic Vein with Intraluminal Device, Percutaneous Approach
05VC3ZZ Restriction of Left Basilic Vein, Percutaneous Approach
05VC4DZ Restriction of Left Basilic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VD0DZ Restriction of Right Cephalic Vein with Intraluminal Device, Open Approach
05VD3DZ Restriction of Right Cephalic Vein with Intraluminal Device, Percutaneous Approach
05VD3ZZ Restriction of Right Cephalic Vein, Percutaneous Approach
05VD4DZ Restriction of Right Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VF0DZ Restriction of Left Cephalic Vein with Intraluminal Device, Open Approach
05VF3DZ Restriction of Left Cephalic Vein with Intraluminal Device, Percutaneous Approach
05VF3ZZ Restriction of Left Cephalic Vein, Percutaneous Approach
05VF4DZ Restriction of Left Cephalic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VG0DZ Restriction of Right Hand Vein with Intraluminal Device, Open Approach
05VG3DZ Restriction of Right Hand Vein with Intraluminal Device, Percutaneous Approach
05VG3ZZ Restriction of Right Hand Vein, Percutaneous Approach
05VG4DZ Restriction of Right Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VH0DZ Restriction of Left Hand Vein with Intraluminal Device, Open Approach
05VH3DZ Restriction of Left Hand Vein with Intraluminal Device, Percutaneous Approach
05VH3ZZ Restriction of Left Hand Vein, Percutaneous Approach
05VH4DZ Restriction of Left Hand Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VL0DZ Restriction of Intracranial Vein with Intraluminal Device, Open Approach
05VL3DZ Restriction of Intracranial Vein with Intraluminal Device, Percutaneous Approach
05VL3ZZ Restriction of Intracranial Vein, Percutaneous Approach
05VL4DZ Restriction of Intracranial Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VM0DZ Restriction of Right Internal Jugular Vein with Intraluminal Device, Open Approach
05VM3DZ Restriction of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Approach
05VM3ZZ Restriction of Right Internal Jugular Vein, Percutaneous Approach
05VM4DZ Restriction of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VN0DZ Restriction of Left Internal Jugular Vein with Intraluminal Device, Open Approach
05VN3DZ Restriction of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Approach
05VN3ZZ Restriction of Left Internal Jugular Vein, Percutaneous Approach
05VN4DZ Restriction of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VP0DZ Restriction of Right External Jugular Vein with Intraluminal Device, Open Approach
05VP3DZ Restriction of Right External Jugular Vein with Intraluminal Device, Percutaneous Approach
05VP3ZZ Restriction of Right External Jugular Vein, Percutaneous Approach
05VP4DZ Restriction of Right External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VQ0DZ Restriction of Left External Jugular Vein with Intraluminal Device, Open Approach
05VQ3DZ Restriction of Left External Jugular Vein with Intraluminal Device, Percutaneous Approach
05VQ3ZZ Restriction of Left External Jugular Vein, Percutaneous Approach
05VQ4DZ Restriction of Left External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VR0DZ Restriction of Right Vertebral Vein with Intraluminal Device, Open Approach
05VR3DZ Restriction of Right Vertebral Vein with Intraluminal Device, Percutaneous Approach
05VR3ZZ Restriction of Right Vertebral Vein, Percutaneous Approach
05VR4DZ Restriction of Right Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VS0DZ Restriction of Left Vertebral Vein with Intraluminal Device, Open Approach
05VS3DZ Restriction of Left Vertebral Vein with Intraluminal Device, Percutaneous Approach
05VS3ZZ Restriction of Left Vertebral Vein, Percutaneous Approach
05VS4DZ Restriction of Left Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 49
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
05VT0DZ Restriction of Right Face Vein with Intraluminal Device, Open Approach
05VT3DZ Restriction of Right Face Vein with Intraluminal Device, Percutaneous Approach
05VT3ZZ Restriction of Right Face Vein, Percutaneous Approach
05VT4DZ Restriction of Right Face Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VV0DZ Restriction of Left Face Vein with Intraluminal Device, Open Approach
05VV3DZ Restriction of Left Face Vein with Intraluminal Device, Percutaneous Approach
05VV3ZZ Restriction of Left Face Vein, Percutaneous Approach
05VV4DZ Restriction of Left Face Vein with Intraluminal Device, Percutaneous Endoscopic Approach
05VY3DZ Restriction of Upper Vein with Intraluminal Device, Percutaneous Approach
05VY3ZZ Restriction of Upper Vein, Percutaneous Approach
06L13ZZ Occlusion of Splenic Vein, Percutaneous Approach
06L23ZZ Occlusion of Gastric Vein, Percutaneous Approach
06L33ZZ Occlusion of Esophageal Vein, Percutaneous Approach
06L43ZZ Occlusion of Hepatic Vein, Percutaneous Approach
06L53ZZ Occlusion of Superior Mesenteric Vein, Percutaneous Approach
06L63ZZ Occlusion of Inferior Mesenteric Vein, Percutaneous Approach
06L73ZZ Occlusion of Colic Vein, Percutaneous Approach
06L83ZZ Occlusion of Portal Vein, Percutaneous Approach
06L93ZZ Occlusion of Right Renal Vein, Percutaneous Approach
06LB3ZZ Occlusion of Left Renal Vein, Percutaneous Approach
06LC0DZ Occlusion of Right Common Iliac Vein with Intraluminal Device, Open Approach
06LC3DZ Occlusion of Right Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06LC3ZZ Occlusion of Right Common Iliac Vein, Percutaneous Approach
06LC4DZ Occlusion of Right Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LD0DZ Occlusion of Left Common Iliac Vein with Intraluminal Device, Open Approach
06LD3DZ Occlusion of Left Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06LD3ZZ Occlusion of Left Common Iliac Vein, Percutaneous Approach
06LD4DZ Occlusion of Left Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LF0DZ Occlusion of Right External Iliac Vein with Intraluminal Device, Open Approach
06LF3DZ Occlusion of Right External Iliac Vein with Intraluminal Device, Percutaneous Approach
06LF3ZZ Occlusion of Right External Iliac Vein, Percutaneous Approach
06LF4DZ Occlusion of Right External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LG0DZ Occlusion of Left External Iliac Vein with Intraluminal Device, Open Approach
06LG3DZ Occlusion of Left External Iliac Vein with Intraluminal Device, Percutaneous Approach
06LG3ZZ Occlusion of Left External Iliac Vein, Percutaneous Approach
06LG4DZ Occlusion of Left External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LH3ZZ Occlusion of Right Hypogastric Vein, Percutaneous Approach
06LJ3ZZ Occlusion of Left Hypogastric Vein, Percutaneous Approach
06LM0DZ Occlusion of Right Femoral Vein with Intraluminal Device, Open Approach
06LM3DZ Occlusion of Right Femoral Vein with Intraluminal Device, Percutaneous Approach
06LM3ZZ Occlusion of Right Femoral Vein, Percutaneous Approach
06LM4DZ Occlusion of Right Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LN0DZ Occlusion of Left Femoral Vein with Intraluminal Device, Open Approach
06LN3DZ Occlusion of Left Femoral Vein with Intraluminal Device, Percutaneous Approach
06LN3ZZ Occlusion of Left Femoral Vein, Percutaneous Approach
06LN4DZ Occlusion of Left Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LP0DZ Occlusion of Right Greater Saphenous Vein with Intraluminal Device, Open Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 50
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06LP3DZ Occlusion of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LP3ZZ Occlusion of Right Greater Saphenous Vein, Percutaneous Approach
06LP4DZ Occlusion of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LQ0DZ Occlusion of Left Greater Saphenous Vein with Intraluminal Device, Open Approach
06LQ3DZ Occlusion of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LQ3ZZ Occlusion of Left Greater Saphenous Vein, Percutaneous Approach
06LQ4DZ Occlusion of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LR0DZ Occlusion of Right Lesser Saphenous Vein with Intraluminal Device, Open Approach
06LR3DZ Occlusion of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LR3ZZ Occlusion of Right Lesser Saphenous Vein, Percutaneous Approach
06LR4DZ Occlusion of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LS0DZ Occlusion of Left Lesser Saphenous Vein with Intraluminal Device, Open Approach
06LS3DZ Occlusion of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06LS3ZZ Occlusion of Left Lesser Saphenous Vein, Percutaneous Approach
06LS4DZ Occlusion of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LT0DZ Occlusion of Right Foot Vein with Intraluminal Device, Open Approach
06LT3DZ Occlusion of Right Foot Vein with Intraluminal Device, Percutaneous Approach
06LT3ZZ Occlusion of Right Foot Vein, Percutaneous Approach
06LT4DZ Occlusion of Right Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LV0DZ Occlusion of Left Foot Vein with Intraluminal Device, Open Approach
06LV3DZ Occlusion of Left Foot Vein with Intraluminal Device, Percutaneous Approach
06LV3ZZ Occlusion of Left Foot Vein, Percutaneous Approach
06LV4DZ Occlusion of Left Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06LY0DZ Occlusion of Lower Vein with Intraluminal Device, Open Approach
06LY3DZ Occlusion of Lower Vein with Intraluminal Device, Percutaneous Approach
06LY3ZZ Occlusion of Lower Vein, Percutaneous Approach
06LY4DZ Occlusion of Lower Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V10DZ Restriction of Splenic Vein with Intraluminal Device, Open Approach
06V13DZ Restriction of Splenic Vein with Intraluminal Device, Percutaneous Approach
06V13ZZ Restriction of Splenic Vein, Percutaneous Approach
06V14DZ Restriction of Splenic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V20DZ Restriction of Gastric Vein with Intraluminal Device, Open Approach
06V23DZ Restriction of Gastric Vein with Intraluminal Device, Percutaneous Approach
06V23ZZ Restriction of Gastric Vein, Percutaneous Approach
06V24DZ Restriction of Gastric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V30DZ Restriction of Esophageal Vein with Intraluminal Device, Open Approach
06V33DZ Restriction of Esophageal Vein with Intraluminal Device, Percutaneous Approach
06V33ZZ Restriction of Esophageal Vein, Percutaneous Approach
06V34DZ Restriction of Esophageal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V40DZ Restriction of Hepatic Vein with Intraluminal Device, Open Approach
06V43DZ Restriction of Hepatic Vein with Intraluminal Device, Percutaneous Approach
06V43ZZ Restriction of Hepatic Vein, Percutaneous Approach
06V44DZ Restriction of Hepatic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V50DZ Restriction of Superior Mesenteric Vein with Intraluminal Device, Open Approach
06V53DZ Restriction of Superior Mesenteric Vein with Intraluminal Device, Percutaneous Approach
06V53ZZ Restriction of Superior Mesenteric Vein, Percutaneous Approach
06V54DZ Restriction of Superior Mesenteric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 51
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06V60DZ Restriction of Inferior Mesenteric Vein with Intraluminal Device, Open Approach
06V63DZ Restriction of Inferior Mesenteric Vein with Intraluminal Device, Percutaneous Approach
06V63ZZ Restriction of Inferior Mesenteric Vein, Percutaneous Approach
06V64DZ Restriction of Inferior Mesenteric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V70DZ Restriction of Colic Vein with Intraluminal Device, Open Approach
06V73DZ Restriction of Colic Vein with Intraluminal Device, Percutaneous Approach
06V73ZZ Restriction of Colic Vein, Percutaneous Approach
06V74DZ Restriction of Colic Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V80DZ Restriction of Portal Vein with Intraluminal Device, Open Approach
06V83DZ Restriction of Portal Vein with Intraluminal Device, Percutaneous Approach
06V83ZZ Restriction of Portal Vein, Percutaneous Approach
06V84DZ Restriction of Portal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06V90DZ Restriction of Right Renal Vein with Intraluminal Device, Open Approach
06V93DZ Restriction of Right Renal Vein with Intraluminal Device, Percutaneous Approach
06V93ZZ Restriction of Right Renal Vein, Percutaneous Approach
06V94DZ Restriction of Right Renal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VB0DZ Restriction of Left Renal Vein with Intraluminal Device, Open Approach
06VB3DZ Restriction of Left Renal Vein with Intraluminal Device, Percutaneous Approach
06VB3ZZ Restriction of Left Renal Vein, Percutaneous Approach
06VB4DZ Restriction of Left Renal Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VC0DZ Restriction of Right Common Iliac Vein with Intraluminal Device, Open Approach
06VC3DZ Restriction of Right Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06VC3ZZ Restriction of Right Common Iliac Vein, Percutaneous Approach
06VC4DZ Restriction of Right Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VD0DZ Restriction of Left Common Iliac Vein with Intraluminal Device, Open Approach
06VD3DZ Restriction of Left Common Iliac Vein with Intraluminal Device, Percutaneous Approach
06VD3ZZ Restriction of Left Common Iliac Vein, Percutaneous Approach
06VD4DZ Restriction of Left Common Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VF0DZ Restriction of Right External Iliac Vein with Intraluminal Device, Open Approach
06VF3DZ Restriction of Right External Iliac Vein with Intraluminal Device, Percutaneous Approach
06VF3ZZ Restriction of Right External Iliac Vein, Percutaneous Approach
06VF4DZ Restriction of Right External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VG0DZ Restriction of Left External Iliac Vein with Intraluminal Device, Open Approach
06VG3DZ Restriction of Left External Iliac Vein with Intraluminal Device, Percutaneous Approach
06VG3ZZ Restriction of Left External Iliac Vein, Percutaneous Approach
06VG4DZ Restriction of Left External Iliac Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VH0DZ Restriction of Right Hypogastric Vein with Intraluminal Device, Open Approach
06VH3DZ Restriction of Right Hypogastric Vein with Intraluminal Device, Percutaneous Approach
06VH3ZZ Restriction of Right Hypogastric Vein, Percutaneous Approach
06VH4DZ Restriction of Right Hypogastric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VJ0DZ Restriction of Left Hypogastric Vein with Intraluminal Device, Open Approach
06VJ3DZ Restriction of Left Hypogastric Vein with Intraluminal Device, Percutaneous Approach
06VJ3ZZ Restriction of Left Hypogastric Vein, Percutaneous Approach
06VJ4DZ Restriction of Left Hypogastric Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VM0DZ Restriction of Right Femoral Vein with Intraluminal Device, Open Approach
06VM3DZ Restriction of Right Femoral Vein with Intraluminal Device, Percutaneous Approach
06VM3ZZ Restriction of Right Femoral Vein, Percutaneous Approach
CORP-224204-AB SEPT2015See page 3 for important information about the uses and limitations of this document. 52
Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
06VM4DZ Restriction of Right Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VN0DZ Restriction of Left Femoral Vein with Intraluminal Device, Open Approach
06VN3DZ Restriction of Left Femoral Vein with Intraluminal Device, Percutaneous Approach
06VN3ZZ Restriction of Left Femoral Vein, Percutaneous Approach
06VN4DZ Restriction of Left Femoral Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VP0DZ Restriction of Right Greater Saphenous Vein with Intraluminal Device, Open Approach
06VP3DZ Restriction of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VP3ZZ Restriction of Right Greater Saphenous Vein, Percutaneous Approach
06VP4DZ Restriction of Right Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VQ0DZ Restriction of Left Greater Saphenous Vein with Intraluminal Device, Open Approach
06VQ3DZ Restriction of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VQ3ZZ Restriction of Left Greater Saphenous Vein, Percutaneous Approach
06VQ4DZ Restriction of Left Greater Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VR0DZ Restriction of Right Lesser Saphenous Vein with Intraluminal Device, Open Approach
06VR3DZ Restriction of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VR3ZZ Restriction of Right Lesser Saphenous Vein, Percutaneous Approach
06VR4DZ Restriction of Right Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VS0DZ Restriction of Left Lesser Saphenous Vein with Intraluminal Device, Open Approach
06VS3DZ Restriction of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Approach
06VS3ZZ Restriction of Left Lesser Saphenous Vein, Percutaneous Approach
06VS4DZ Restriction of Left Lesser Saphenous Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VT0DZ Restriction of Right Foot Vein with Intraluminal Device, Open Approach
06VT3DZ Restriction of Right Foot Vein with Intraluminal Device, Percutaneous Approach
06VT3ZZ Restriction of Right Foot Vein, Percutaneous Approach
06VT4DZ Restriction of Right Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VV0DZ Restriction of Left Foot Vein with Intraluminal Device, Open Approach
06VV3DZ Restriction of Left Foot Vein with Intraluminal Device, Percutaneous Approach
06VV3ZZ Restriction of Left Foot Vein, Percutaneous Approach
06VV4DZ Restriction of Left Foot Vein with Intraluminal Device, Percutaneous Endoscopic Approach
06VY3DZ Restriction of Lower Vein with Intraluminal Device, Percutaneous Approach
06VY3ZZ Restriction of Lower Vein, Percutaneous Approach
02CP3ZZ Extirpation of Matter from Pulmonary Trunk, Percutaneous Approach
02CQ3ZZ Extirpation of Matter from Right Pulmonary Artery, Percutaneous Approach
02CR3ZZ Extirpation of Matter from Left Pulmonary Artery, Percutaneous Approach
02CS3ZZ Extirpation of Matter from Right Pulmonary Vein, Percutaneous Approach
02CT3ZZ Extirpation of Matter from Left Pulmonary Vein, Percutaneous Approach
02CV3ZZ Extirpation of Matter from Superior Vena Cava, Percutaneous Approach
02CW3ZZ Extirpation of Matter from Thoracic Aorta, Percutaneous Approach
03C03ZZ Extirpation of Matter from Right Internal Mammary Artery, Percutaneous Approach
03C13ZZ Extirpation of Matter from Left Internal Mammary Artery, Percutaneous Approach
03C23ZZ Extirpation of Matter from Innominate Artery, Percutaneous Approach
03C33ZZ Extirpation of Matter from Right Subclavian Artery, Percutaneous Approach
03C43ZZ Extirpation of Matter from Left Subclavian Artery, Percutaneous Approach
03C53ZZ Extirpation of Matter from Right Axillary Artery, Percutaneous Approach
03C63ZZ Extirpation of Matter from Left Axillary Artery, Percutaneous Approach
03C73ZZ Extirpation of Matter from Right Brachial Artery, Percutaneous Approach
03C83ZZ Extirpation of Matter from Left Brachial Artery, Percutaneous Approach
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Peripheral Interventions
ICD‐9Code
ICD‐9 Description
ICD‐10 PCSCode ICD‐10 PCS Description
39.79
Other endovascular procedures on other vessels
03C93ZZ Extirpation of Matter from Right Ulnar Artery, Percutaneous Approach
03CA3ZZ Extirpation of Matter from Left Ulnar Artery, Percutaneous Approach
03CB3ZZ Extirpation of Matter from Right Radial Artery, Percutaneous Approach
03CC3ZZ Extirpation of Matter from Left Radial Artery, Percutaneous Approach
03CD3ZZ Extirpation of Matter from Right Hand Artery, Percutaneous Approach
03CF3ZZ Extirpation of Matter from Left Hand Artery, Percutaneous Approach
03CY3ZZ Extirpation of Matter from Upper Artery, Percutaneous Approach
04C03ZZ Extirpation of Matter from Abdominal Aorta, Percutaneous Approach
04C13ZZ Extirpation of Matter from Celiac Artery, Percutaneous Approach
04C23ZZ Extirpation of Matter from Gastric Artery, Percutaneous Approach
04C33ZZ Extirpation of Matter from Hepatic Artery, Percutaneous Approach
04C43ZZ Extirpation of Matter from Splenic Artery, Percutaneous Approach
04C53ZZ Extirpation of Matter from Superior Mesenteric Artery, Percutaneous Approach
04C63ZZ Extirpation of Matter from Right Colic Artery, Percutaneous Approach
04C73ZZ Extirpation of Matter from Left Colic Artery, Percutaneous Approach
04C83ZZ Extirpation of Matter from Middle Colic Artery, Percutaneous Approach
04C93ZZ Extirpation of Matter from Right Renal Artery, Percutaneous Approach
04CA3ZZ Extirpation of Matter from Left Renal Artery, Percutaneous Approach
04CB3ZZ Extirpation of Matter from Inferior Mesenteric Artery, Percutaneous Approach
04CC3ZZ Extirpation of Matter from Right Common Iliac Artery, Percutaneous Approach
04CD3ZZ Extirpation of Matter from Left Common Iliac Artery, Percutaneous Approach
04CE3ZZ Extirpation of Matter from Right Internal Iliac Artery, Percutaneous Approach
04CF3ZZ Extirpation of Matter from Left Internal Iliac Artery, Percutaneous Approach
04CH3ZZ Extirpation of Matter from Right External Iliac Artery, Percutaneous Approach
04CJ3ZZ Extirpation of Matter from Left External Iliac Artery, Percutaneous Approach
04CK3ZZ Extirpation of Matter from Right Femoral Artery, Percutaneous Approach
04CL3ZZ Extirpation of Matter from Left Femoral Artery, Percutaneous Approach
04CM3ZZ Extirpation of Matter from Right Popliteal Artery, Percutaneous Approach
04CN3ZZ Extirpation of Matter from Left Popliteal Artery, Percutaneous Approach
04CP3ZZ Extirpation of Matter from Right Anterior Tibial Artery, Percutaneous Approach
04CQ3ZZ Extirpation of Matter from Left Anterior Tibial Artery, Percutaneous Approach
04CR3ZZ Extirpation of Matter from Right Posterior Tibial Artery, Percutaneous Approach
04CS3ZZ Extirpation of Matter from Left Posterior Tibial Artery, Percutaneous Approach
04CT3ZZ Extirpation of Matter from Right Peroneal Artery, Percutaneous Approach
04CU3ZZ Extirpation of Matter from Left Peroneal Artery, Percutaneous Approach
04CV3ZZ Extirpation of Matter from Right Foot Artery, Percutaneous Approach
04CW3ZZ Extirpation of Matter from Left Foot Artery, Percutaneous Approach
04CY3ZZ Extirpation of Matter from Lower Artery, Percutaneous Approach
05C03ZZ Extirpation of Matter from Azygos Vein, Percutaneous Approach
05C13ZZ Extirpation of Matter from Hemiazygos Vein, Percutaneous Approach
05C33ZZ Extirpation of Matter from Right Innominate Vein, Percutaneous Approach
05C43ZZ Extirpation of Matter from Left Innominate Vein, Percutaneous Approach
05C53ZZ Extirpation of Matter from Right Subclavian Vein, Percutaneous Approach
05C63ZZ Extirpation of Matter from Left Subclavian Vein, Percutaneous Approach
05C73ZZ Extirpation of Matter from Right Axillary Vein, Percutaneous Approach
05C83ZZ Extirpation of Matter from Left Axillary Vein, Percutaneous Approach
05C93ZZ Extirpation of Matter from Right Brachial Vein, Percutaneous Approach
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Rhythm Management and Electrophysiology
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
00.50
Implantation of cardiac resynchronization pacemaker without mention of defibrillation, total system [CRT-P]
0JH607ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH637ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH807ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH837ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
02HK3JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Approach
02HK4JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL3JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Approach
02HL4JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Endoscopic Approach
02H43JZ Insertion of Pacemaker Lead into Coronary Vein, Percutaneous Approach
02H44JZ Insertion of Pacemaker Lead into Coronary Vein, Percutaneous Endoscopic Approach
02H63JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Approach
02H64JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Endoscopic Approach
00.51
Implantation of cardiac resynchronization defibrillator, total system [CRT-D]
0JH609ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH639ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH809ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH839ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
02HK3KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Approach
02HK4KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL3KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Approach
02HL4KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Endoscopic Approach
00.52
Implantation or replacement of transvenous lead [electrode] into left ventricular coronary venous system
02H43JZ Insertion of Pacemaker Lead into Coronary Vein, Percutaneous Approach
02PA4MZ Removal of Cardiac Lead from Heart, Percutaneous Endoscopic Approach
02PA0MZ Removal of Cardiac Lead from Heart, Open Approach
02PA3MZ Removal of Cardiac Lead from Heart, Percutaneous Approach
0.53
Implantation or replacement of cardiac resynchronization pacemaker pulse generator only [CRT-P]
0JH607ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH637ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH807ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH837ZInsertion of Cardiac Resynchronization Pacemaker Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
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Rhythm Management and Electrophysiology
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
00.54
Implantation or replacement of cardiac resynchronization defibrillator pulse generator device only [CRT-D]
0JH609ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH639ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH809ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH839ZInsertion of Cardiac Resynchronization Defibrillator Pulse Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
37.20Noninvasive programmed electrical stimulation [NIPS]
4A02X4Z Measurement of Cardiac Electrical Activity, External Approach
4A02XFZ Measurement of Cardiac Rhythm, External Approach
37.26
Catheter based invasive electrophysiologic testing Electrophysiologic studies [EPS]
02K80ZZ Map Conduction Mechanism, Open Approach
02K83ZZ Map Conduction Mechanism, Percutaneous Approach
02K84ZZ Map Conduction Mechanism, Percutaneous Endoscopic Approach
37.27 Cardiac mapping
02K80ZZ Map Conduction Mechanism, Open Approach
02K83ZZ Map Conduction Mechanism, Percutaneous Approach
02K84ZZ Map Conduction Mechansim, Percustaneous Endoscopic Approach
37.28Intracardiacechocardiography [ICE]
B244YZZ Ultrasonography of Right Heart using Other Contrast
B244ZZZ Ultrasonography of Right Heart
B245YZZ Ultrasonography of Left Heart using Other Contrast
B245ZZZ Ultrasonography of Left Heart
B246YZZ Ultrasonography of Right and Left Heart using Other Contrast
B246ZZZ Ultrasonography of Right and Left Heart
B24DYZZ Ultrasonography of Pediatric Heart using Other Contrast
B24DZZZ Ultrasonography of Pediatric Heart
37.29Other diagnosticprocedures on heart andpericardium
4A023FZ Measurement of Cardiac Rhythm, Percutaneous Approach
37.34 Excision or destruction of other lesion or tissue of heart, endovascular approach
02563ZZ Destruction of Right Atrium, Percutaneous Approach
02573ZZ Destruction of Left Atrium, Percutaneous Approach
025K3ZZ Destruction of Right Ventricle, Percutaneous Approach
025L3ZZ Destruction of Left Ventricle, Percutaneous Approach
02B63ZZ Excision of Right Atrium, Percutaneous Approach
02B73ZZ Excision of Left Atrium, Percutaneous Approach
02BK3ZZ Excision of Right Ventricle, Percutaneous Approach
02BL3ZZ Excision of Left Ventricle, Percutaneous Approach
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
37.70 Initial insertion of lead [electrode], not otherwise specified
02H44JZ Insertion of Pacemaker Lead into Coronary Vein, Percutaneous Endoscopic Approach
02H44MZ Insertion of Cardiac Lead into Coronary Vein, Percutaneous Endoscopic Approach
02H43JZ Insertion of Pacemaker Lead into Coronary Vein, Percutaneous Approach
02H43MZ Insertion of Cardiac Lead into Coronary Vein, Percutaneous Approach
02H63JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Approach
02H63MZ Insertion of Cardiac Lead into Right Atrium, Percutaneous Approach
02H64JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Endoscopic Approach
02H64MZ Insertion of Cardiac Lead into Right Atrium, Percutaneous Endoscopic Approach
02H73JZ Insertion of Pacemaker Lead into Left Atrium, Percutaneous Approach
02H73MZ Insertion of Cardiac Lead into Left Atrium, Percutaneous Approach
02H74JZ Insertion of Pacemaker Lead into Left Atrium, Percutaneous Endoscopic Approach
02H74MZ Insertion of Cardiac Lead into Left Atrium, Percutaneous Endoscopic Approach
02HK3JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Approach
02HK3MZ Insertion of Cardiac Lead into Right Ventricle, Percutaneous Approach
02HK4JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HK4MZ Insertion of Cardiac Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL3JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Approach
02HL3MZ Insertion of Cardiac Lead into Left Ventricle, Percutaneous Approach
02HL4JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Endoscopic Approach
37.71Initial insertion of transvenous lead [electrode] into ventricle
02HK3JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Approach
02HL3JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Approach
02HK4JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL4JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Endoscopic Approach
37.72
Initial insertion of transvenous leads [electrodes] into atrium and ventricle
02H64JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Endoscopic Approach
02H74JZ Insertion of Pacemaker Lead into Left Atrium, Percutaneous Endoscopic Approach
02HK4JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL4JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Endoscopic Approach
37.73Initial insertion of transvenous lead [electrode] into atrium
02H64JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Endoscopic Approach
02H74JZ Insertion of Pacemaker Lead into Left Atrium, Percutaneous Endoscopic Approach
37.74Insertion or replacement of epicardial lead [electrode] into epicardium
02HN0JZ Insertion of Pacemaker Lead into Pericardium, Open Approach
02HN0MZ Insertion of Cardiac Lead into Pericardium, Open Approach
02HN3JZ Insertion of Pacemaker Lead into Pericardium, Percutaneous Approach
02HN3MZ Insertion of Cardiac Lead into Pericardium, Percutaneous Approach
02HN4JZ Insertion of Pacemaker Lead into Pericardium, Percutaneous Endoscopic Approach
02HN4MZ Insertion of Cardiac Lead into Pericardium, Percutaneous Endoscopic Approach
02PA0MZ Removal of Cardiac Lead from Heart, Open Approach
02PA3MZ Removal of Cardiac Lead from Heart, Percutaneous Approach
02PA4MZ Removal of Cardiac Lead from Heart, Percutaneous Endoscopic Approach
02HN0KZ Insertion of Defibrillator Lead into Pericardium, Open Approach
02HN3KZ Insertion of Defibrillator Lead into Pericardium, Percutaneous Approach
02HN4KZ Insertion of Defibrillator Lead into Pericardium, Percutaneous Endoscopic Approach
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Rhythm Management and Electrophysiology
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
37.75 Revision of lead [electrode]
02WA0MZ Revision of Cardiac Lead in Heart, Open Approach
02WA3MZ Revision of Cardiac Lead in Heart, Percutaneous Approach
02WA4MZ Revision of Cardiac Lead in Heart, Percutaneous Endoscopic Approach
0JWT0PZRevision of Cardiac Rhythm Related Device in Trunk Subcutaneous Tissue and Fascia, Open Approach
37.76 Replacement of transvenous atrial and/or ventricular lead(s) [electrode]
02H63JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Approach
02H64JZ Insertion of Pacemaker Lead into Right Atrium, Percutaneous Endoscopic Approach
02H73JZ Insertion of Pacemaker Lead into Left Atrium, Percutaneous Approach
02H74JZ Insertion of Pacemaker Lead into Left Atrium, Percutaneous Endoscopic Approach
02HK3JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Approach
02HK4JZ Insertion of Pacemaker Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL3JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Approach
02HL4JZ Insertion of Pacemaker Lead into Left Ventricle, Percutaneous Endoscopic Approach
37.77 Removal of lead(s) [electrode] without replacement
02PA0MZ Removal of Cardiac Lead from Heart, Open Approach
02PA3MZ Removal of Cardiac Lead from Heart, Percutaneous Approach
02PA4MZ Removal of Cardiac Lead from Heart, Percutaneous Endoscopic Approach
02PAXMZ Removal of Cardiac Lead from Heart, External Approach
37.78Revision or relocation of cardiac device pocket
5A1213Z Performance of Cardiac Pacing, Intermittent
5A1223Z Performance of Cardiac Pacing, Continuous
37.79 Revision or relocation of cardiac device pocket
0JWT0PZRevision of Cardiac Rhythm Related Device in Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPTOPZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
OJPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
02WA3MZ Revision of Cardiac Lead in Heart, Percutaneous Approach
02WA4MZ Revision of Cardiac Lead in Heart, Percutaneous Endoscopic Approach
02WA0MZ Revision of Cardiac Lead in Heart, Open Approach
0JH632Z Insertion of Monitoring Device into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH602Z Insertion of Monitoring Device into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH832ZInsertion of Monitoring Device into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH802Z Insertion of Monitoring Device into Abdomen Subcutaneous Tissue and Fascia, Open Approach
37.80
Insertion of permanent pacemaker, initial or replacement, type of device not specified
0JH60PZInsertion of Cardiac Rhythm Related Device into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH63PZInsertion of Cardiac Rhythm Related Device into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH80PZInsertion of Cardiac Rhythm Related Device into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH83PZInsertion of Cardiac Rhythm Related Device into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
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Rhythm Management and Electrophysiology
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
37.81 Initial insertion of single-Chamber device; not specified as rate responsive
0JH604Z Insertion of Pacemaker, Single Chamber into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH634ZInsertion of Pacemaker, Single Chamber into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH804ZInsertion of Pacemaker, Single Chamber into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH834ZInsertion of Pacemaker, Single Chamber into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
37.82Initial insertion of single-Chamber device, rate responsive
0JH605ZInsertion of Pacemaker, Single Chamber Rate Responsive into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH635ZInsertion of Pacemaker, Single Chamber Rate Responsive into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH805ZInsertion of Pacemaker, Single Chamber Rate Responsive into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH835ZInsertion of Pacemaker, Single Chamber Rate Responsive into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
37.83Initial insertion of dual-Chamber device
0JH606Z Insertion of Pacemaker, Dual Chamber into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH636ZInsertion of Pacemaker, Dual Chamber into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH806ZInsertion of Pacemaker, Dual Chamber into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH836ZInsertion of Pacemaker, Dual Chamber into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
37.85
Replacement of any type pacemaker device with single-chamber device, not specified as rate responsive
0JH604Z Insertion of Pacemaker, Single Chamber into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH634ZInsertion of Pacemaker, Single Chamber into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH804ZInsertion of Pacemaker, Single Chamber into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH834ZInsertion of Pacemaker, Single Chamber into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
37.86
Replacement of any type of pacemaker device with single-Chamber device rate responsive
0JH605ZInsertion of Pacemaker, Single Chamber Rate Responsive into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH635ZInsertion of Pacemaker, Single Chamber Rate Responsive into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH805ZInsertion of Pacemaker, Single Chamber Rate Responsive into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH835ZInsertion of Pacemaker, Single Chamber Rate Responsive into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
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Rhythm Management and Electrophysiology
CORP-224204-AB SEPT2015Note: No Boston Scientific products are approved for sale in the US for atrial fibrillation ablations.See page 3 for important information about the uses and limitations of this document. 60
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
37.87Replacement of any type pacemaker device with dual-Chamber device
0JH606Z Insertion of Pacemaker, Dual Chamber into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH636ZInsertion of Pacemaker, Dual Chamber into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH806ZInsertion of Pacemaker, Dual Chamber into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH836ZInsertion of Pacemaker, Dual Chamber into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
37.89Revision or removal of pacemaker device
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
0JWT0PZ Revision of Cardiac Rhythm Related Device in Trunk Subcutaneous Tissue and Fascia, Open Approach
0JWT3PZRevision of Cardiac Rhythm Related Device in Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
37.90Insertion of left atrial appendage device
02L73DK Occlusion of Left Atrial Appendage with Intraluminal Device, Percutaneous Approach
37.94
Implantation or replacement of automatic cardioverter/defibrillator, total system [AICD]
02H63KZ Insertion of Defibrillator Lead into Right Atrium, Percutaneous Approach
02H64KZ Insertion of Defibrillator Lead into Right Atrium, Percutaneous Endoscopic Approach
02H73KZ Insertion of Defibrillator Lead into Left Atrium, Percutaneous Approach
02H74KZ Insertion of Defibrillator Lead into Left Atrium, Percutaneous Endoscopic Approach
02HK3KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Approach
02HK4KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL3KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Approach
02HL4KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Endoscopic Approach
02PA0MZ Removal of Cardiac Lead from Heart, Open Approach
02PA3MZ Removal of Cardiac Lead from Heart, Percutaneous Approach
02PA4MZ Removal of Cardiac Lead from Heart, Percutaneous Endoscopic Approach
0JH608Z Insertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH638ZInsertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH808Z Insertion of Defibrillator Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH838ZInsertion of Defibrillator Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH60PZInsertion of Cardiac Rhythm Related Device into Chest Subcutaneous Tissue and Fascia, Open Approach
Rhythm Management and Electrophysiology
ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
37.95 Implantation of automatic cardioverter/defibrillator lead(s) only
02H63KZ Insertion of Defibrillator Lead into Right Atrium, Percutaneous Approach
02H73KZ Insertion of Defibrillator Lead into Left Atrium, Percutaneous Approach
02HK3KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Approach
02HL3KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Approach
0JH60PZInsertion of Cardiac Rhythm Related Device into Chest Subcutaneous Tissue and Fascia, Open Approach
37.96 Implantation of automatic cardioverter/defibrillator pulse generator only
0JH608Z Insertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH638ZInsertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH808Z Insertion of Defibrillator Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH838ZInsertion of Defibrillator Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
37.97Replacement of automatic cardioverter/defibrillator lead(s) only
02H63KZ Insertion of Defibrillator Lead into Right Atrium, Percutaneous Approach
02H64KZ Insertion of Defibrillator Lead into Right Atrium, Percutaneous Endoscopic Approach
02H73KZ Insertion of Defibrillator Lead into Left Atrium, Percutaneous Approach
02H74KZ Insertion of Defibrillator Lead into Left Atrium, Percutaneous Endoscopic Approach
02HK3KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Approach
02HK4KZ Insertion of Defibrillator Lead into Right Ventricle, Percutaneous Endoscopic Approach
02HL3KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Approach
02HL4KZ Insertion of Defibrillator Lead into Left Ventricle, Percutaneous Endoscopic Approach
02PA0MZ Removal of Cardiac Lead from Heart, Open Approach
02PA3MZ Removal of Cardiac Lead from Heart, Percutaneous Approach
02PA4MZ Removal of Cardiac Lead from Heart, Percutaneous Endoscopic Approach
0JH60PZInsertion of Cardiac Rhythm Related Device into Chest Subcutaneous Tissue and Fascia, Open Approach
0JPTOPZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
37.98 Replacement of automatic cardioverter/defibrillator pulse generator only
0JH608Z Insertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
0JH638ZInsertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH808Z Insertion of Defibrillator Generator into Abdomen Subcutaneous Tissue and Fascia, Open Approach
0JH838ZInsertion of Defibrillator Generator into Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach
0JPT0PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Open Approach
0JPT3PZRemoval of Cardiac Rhythm Related Device from Trunk Subcutaneous Tissue and Fascia, Percutaneous Approach
0JH608Z Insertion of Defibrillator Generator into Chest Subcutaneous Tissue and Fascia, Open Approach
89.45Artificial pacemaker rate check
4B02XSZ Measurement of Cardiac Pacemaker, External Approach
89.46Artificial pacemaker artifact wave form check
4B02XSZ Measurement of Cardiac Pacemaker, External Approach
89.47Artificial pacemaker electrode impedance check
4B02XSZ Measurement of Cardiac Pacemaker, External Approach
89.48Artificial pacemaker voltage or amperage threshold check
4B02XSZ Measurement of Cardiac Pacemaker, External Approach
89.49Automatic implantable cardioverter/defibrillator (AICD) check
4B02XTZ Measurement of Cardiac Defibrillator, External Approach
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
40.3 Regional lymph node excision
07B30ZZ Excision of Right Upper Extremity Lymphatic, Open Approach
07B34ZZExcision of Right Upper Extremity Lymphatic, Percutaneous Endoscopic Approach
07BC3ZZ Excision of Pelvis Lymphatic, Percutaneous Approach
07BC0ZZ Excision of Pelvis Lymphatic, Open Approach
07BC4ZZ Excision of Pelvis Lymphatic, Percutaneous Endoscopic Approach
07BG4ZZExcision of Left Lower Extremity Lymphatic, Percutaneous Endoscopic Approach
07BG0ZZ Excision of Left Lower Extremity Lymphatic, Open Approach
07BF0ZZ Excision of Right Lower Extremity Lymphatic, Open Approach
07BF4ZZExcision of Right Lower Extremity Lymphatic, Percutaneous Endoscopic Approach
07BD4ZZ Excision of Aortic Lymphatic, Percutaneous Endoscopic Approach
07BD0ZZ Excision of Aortic Lymphatic, Open Approach
07BD3ZZ Excision of Aortic Lymphatic, Percutaneous Approach
07B00ZZ Excision of Head Lymphatic, Open Approach
07B04ZZ Excision of Head Lymphatic, Percutaneous Endoscopic Approach
07B40ZZ Excision of Left Upper Extremity Lymphatic, Open Approach
07B44ZZExcision of Left Upper Extremity Lymphatic, Percutaneous Endoscopic Approach
07B70ZZ Excision of Thorax Lymphatic, Open Approach
07B74ZZ Excision of Thorax Lymphatic, Percutaneous Endoscopic Approach
07BB4ZZ Excision of Mesenteric Lymphatic, Percutaneous Endoscpic Approach
07BB0ZZ Excision of Mesenteric Lymphatic, Open Approach
40.53 Radical excision of iliac lymph nodes
07BC0ZZ Excision of Pelvis Lymphatic, Open Approach
07TC4ZZ Resection of Pelvis Lymphatic, Percutaneous Endoscopic Approach
07TC0ZZ Resection of Pelvis Lymphatic, Open Approach
40.59 Radical excision of other lymph nodes
07B80ZZ Excision of Right Internal Mammary Lymphatic, Open Approach
07B90ZZ Excision of Left Internal Mammary Lymphatic, Open Approach
07T90ZZ Resection of Left Internal Mammary Lymphatic, Open Approach
07T94ZZResection of Left Internal Mammary Lymphatic, Percutaneous Endoscopic Approach
07T80ZZ Resection of Right Internal Mammary Lymphatic, Open Approach
07T84ZZResection of Right Internal Mammary Lymphatic, Percutaneous Endoscopic Approach
55.03 Percutaneous nephrostomy without fragmentation
0T9030Z Drainage of Right Kidney with Drainage Device, Perc Approach
0T9040Z Drainage of Right Kidney with Drain Dev, Perc Endo Approach
0T9130Z Drainage of Left Kidney with Drainage Device, Perc Approach
0T9140Z Drainage of Left Kidney with Drain Dev, Perc Endo Approach
0TC03ZZ Extirpation of Matter from Right Kidney, Perc Approach
0TC04ZZ Extirpation of Matter from Right Kidney, Perc Endo Approach
0TC13ZZ Extirpation of Matter from Left Kidney, Perc Approach
0TC14ZZ Extirpation of Matter from Left Kidney, Perc Endo Approach
OTC43ZZ Extirpation of Matter from Left Kidney Pelvis, Percutaneous Approach
OTC44ZZExtirpation of Matter from Left Kidney Pelvis, Percutaneous Endoscopic Approach
55.04 Percutaneous nephrostomy with fragmentation
0TF33ZZ Fragmentation in Right Kidney Pelvis, Percutaneous Approach
0TF43ZZ Fragmentation in Left Kidney Pelvis, Percutaneous Approach
0TF44ZZ Fragmentation in Left Kidney Pelvis, Perc Endo Approach
OTF34ZZ Fragmentation in Right Kidney Pelvis, Percutaneous Endoscopic Approach
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
56.0Transurethral removal of obstruction from ureter and renal pelvis
0TC37ZZ Extirpation of Matter from Right Kidney Pelvis, Via Opening
0TC38ZZ Extirpation of Matter from Right Kidney Pelvis, Endo
0TC47ZZ Extirpation of Matter from Left Kidney Pelvis, Via Opening
0TC48ZZ Extirpation of Matter from Left Kidney Pelvis, Endo
0TC67ZZ Extirpation of Matter from Right Ureter, Via Opening
0TC68ZZ Extirpation of Matter from Right Ureter, Endo
0TC77ZZ Extirpation of Matter from Left Ureter, Via Opening
0TC78ZZ Extirpation of Matter from Left Ureter, Endo
57.0 Transuretheral clearance of bladder
0T9B7ZZ Drainage of Bladder, Via Natural or Artificial Opening
0T9B8ZZ Drainage of Bladder, Endo
0TCB7ZZ Extirpation of Matter from Bladder, Via Opening
0TCB8ZZ Extirpation of Matter from Bladder, Endo
59.95 Utrasonic Fragmentation of Urinary Stones
0TF30ZZ Fragmentation in Right Kidney Pelvis, Open Approach
0TF37ZZ Fragmentation in Right Kidney Pelvis, Via Opening
0TF38ZZ Fragmentation in Right Kidney Pelvis, Endo
0TF40ZZ Fragmentation in Left Kidney Pelvis, Open Approach
0TF47ZZ Fragmentation in Left Kidney Pelvis, Via Opening
0TF48ZZ Fragmentation in Left Kidney Pelvis, Endo
0TF60ZZ Fragmentation in Left Kidney Pelvis, Endo
0TF63ZZ Fragmentation in Right Ureter, Percutaneous Approach
0TF64ZZ Fragmentation in Right Ureter, Percutaneous Endoscopic Approach
0TF67ZZ Fragmentation in Right Ureter, Via Natural or Artificial Opening
0TF68ZZ Fragmentation in Right Ureter, Via Natural or Artificial Opening Endoscopic
0TF70ZZ Fragmentation in Right Ureter, Perc Endo Approach
0TF73ZZ Fragmentation in Left Ureter, Percutaneous Approach
0TF74ZZ Fragmentation in Left Ureter, Perc Endo Approach
0TF77ZZ Fragmentation in Left Ureter, Via Opening
0TF78ZZ Fragmentation in Left Ureter, Endo
0TFB0ZZ Fragmentation in Bladder, Open Approach
0TFB3ZZ Fragmentation in Bladder, Percutaneous Approach
0TFB4ZZ Fragmentation in Bladder, Percutaneous Endoscopic Approach
0TFB7ZZ Fragmentation in Bladder, Via Natural or Artificial Opening
0TFB8ZZ Fragmentation in Bladder, Endo
0TFC0ZZ Fragmentation in Bladder Neck, Open Approach
0TFC3ZZ Fragmentation in Bladder Neck, Percutaneous Approach
0TFC4ZZ Fragmentation in Bladder Neck, Perc Endo Approach
0TFC7ZZ Fragmentation in Bladder Neck, Via Opening
0TFC8ZZ Fragmentation in Bladder Neck, Endo
0TFD0ZZ Fragmentation in Urethra, Open Approach
0TFD3ZZ Fragmentation in Urethra, Percutaneous Approach
0TFD4ZZ Fragmentation in Urethra, Percutaneous Endoscopic Approach
0TFD7ZZ Fragmentation in Urethra, Via Natural or Artificial Opening
0TFD8ZZ Fragmentation in Urethra, Endo
0WFR0ZZ Fragmentation in Genitourinary Tract, Open Approach
0WFR3ZZ Fragmentation in Genitourinary Tract, Percutaneous Approach
0WFR4ZZ Fragmentation in Genitourinary Tract, Perc Endo Approach
0WFR7ZZ Fragmentation in Genitourinary Tract, Via Opening
0WFR8ZZFragmentation in Genitourinary Tract, Via Natural or Artificial Opening Endoscopic
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
60.21 Transurethral guided laser induced prostatectomy
0V508ZZ Destruction of Prostate, Via Natural or Artificial Opening Endoscopic
0V507ZZ Destruction of Prostate, Via Natural or Artificial Opening
0VT07ZZ Resection of Prostate, Via Natural or Artificial Opening
0VT08ZZ Resection of Prostate, Via Natural or Artificial Opening Endoscopic
0VB07ZZ Excision of Prostate, Via Natural or Artificial Opening
0VB08ZZ Excision of Prostate, Via Natural or Artificial Opening Endoscopic
60.29 Other transurethral prostatectomy
0VB07ZZ Excision of Prostate, Via Natural or Artificial Opening
0VB08ZZ Excision of Prostate, Endo
0VT07ZZ Resection of Prostate, Via Natural or Artificial Opening
0VT08ZZ Resection of Prostate, Endo
60.30 Suprapubic prostatectomy; transvesical prostatectomy 0VT00ZZ Resection of Prostate, Open Approach
60.4 Retropubic prostatecotmy 0VT00ZZ Resection of Prostate, Open Approach
60.5 Radical postatectomy
0VT00ZZ Resection of Prostate, Open Approach
0VT04ZZ Resection of Prostate, Percutaneous Endoscopic Approach
0VT07ZZ Resection of Prostate, Via Natural or Artificial Opening
0VT08ZZ Resection of Prostate, Endo
0VT30ZZ Resection of Bilateral Seminal Vesicles, Open Approach
0VT34ZZ Resection of Bilateral Seminal Vesicles, Perc Endo Approach
60.93 Repair of prostate
0VQ00ZZ Repair Prostate, Open Approach
0VQ03ZZ Repair Prostate, Percutaneous Approach
0VQ04ZZ Repair Prostate, Percutaneous Endoscopic Approach
0VQ07ZZ Repair Prostate, Via Natural or Artificial Opening
0VQ08ZZ Repair Prostate, Endo
0VN07ZZ Release Prosate, Via Natural or Artificial Opening
0VN08ZZ Release Prostate, Via Natural or Artificial Opening Endoscopic
0VN03ZZ Release Prostate, Percutaneous Approach
0VN00ZZ Release Prostate, Open Approach
0VN04ZZ Release Prostate, Percutaneous Endoscopic Approach
98.51 Extracorporeal shockwave lithotripsy (ESWL) of the kidney, ureter and/or bladder
0TF3XZZ Fragmentation in Right Kidney Pelvis, External Approach
0TF4XZZ Fragmentation in Left Kidney Pelvis, External Approach
0TF6XZZ Fragmentation in Right Ureter, External Approach
0TF7XZZ Fragmentation in Left Ureter, External Approach
0TFBXZZ Fragmentation in Bladder, External Approach
0TFCXZZ Fragmentation in Bladder Neck, External Approach
0WFRXZZ Fragmentation in Genitourinary Tract, External Approach
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
59.4 Suprapubic sling operation0TSC0ZZ Reposition Bladder Neck, Open Approach
0TSC4ZZ Reposition Bladder Neck, Percutaneous Endoscopic Approach
59.71 Levator muscle operation for urethrovesical suspension
0TUC07Z Supplement Bladder Neck with Autol Sub, Open Approach
0TUC0KZ Supplement Bladder Neck with Autol Sub, Open Approach
0TUC47Z Supplement Bladder Neck with Autol Sub, Perc Endo Approach
0TUC4KZ Supplement Bladder Neck with Nonaut Sub, Perc Endo Approach
0TUC77Z Supplement Bladder Neck with Autol Sub, Via Opening
0TUC7KZ Supplement Bladder Neck with Nonaut Sub, Via Opening
0TUC87Z Supplement Bladder Neck with Autol Sub, Endo
0TUC8KZ Supplement Bladder Neck with Nonaut Sub, Endo
59.79 Other repairs of stress incontinence
0TQD0ZZ Repair Urethra, Open Approach
0TQD3ZZ Repair Urethra, Percutaneous Approach
0TQD4ZZ Repair Urethra, Percutaneous Endoscopic Approach
0TQD7ZZ Repair Urethra, Via Natural or Artificial Opening
0TQD8ZZ Repair Urethra, Via Natural or Artificial Opening Endoscopic
0TQDXZZ Repair Urethra, External Approach
0TUC0JZ Supplement Bladder Neck with Synth Sub, Via Opening
0TUC4JZ Supplement Bladder Neck with Synth Sub, Perc Endo Approach
0TUC7JZ Supplement Bladder Neck with Synth Sub, Via Opening
0TUC8JZ Supplement Bladder Neck with Synthetic Substitute, Endo
59.79 Other repairs of stress incontinence
0TQD0ZZ Repair Urethra, Open Approach
0TQD3ZZ Repair Urethra, Percutaneous Approach
0TQD4ZZ Repair Urethra, Percutaneous Endoscopic Approach
0TQD7ZZ Repair Urethra, Via Natural or Artificial Opening
0TQD8ZZ Repair Urethra, Via Natural or Artificial Opening Endoscopic
0TQDXZZ Repair Urethra, External Approach
0TUC0JZ Supplement Bladder Neck with Synth Sub, Via Opening
0TUC4JZ Supplement Bladder Neck with Synth Sub, Perc Endo Approach
0TUC7JZ Supplement Bladder Neck with Synth Sub, Via Opening
0TUC8JZ Supplement Bladder Neck with Synthetic Substitute, Endo
70.51 Repair of cystocele 0JQC3ZZ Repair Pelvic Subcu/Fascia, Perc Approach
0JQC0ZZ Repair Pelvic Region Subcutaneous Tissue and Fascia, Open Approach
70.54Repair of cystocele with graft or prosthesis (anterior colporrhaphy)
0JUC0KZ Supplement Pelvic Subcu/Fascia w Nonaut Sub, Open
0JUC0JZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Synthetic Substitute, Open Approach
0JUC3JZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Synthetic Substitute, Percutaneous Approach
0JUC3KZSupplement of Pelvic Region Subcutaneous Tissue and Fascia with Nonautologous Tissue Substitute, Percutaneous Approach
70.77 Vaginal suspension and fixation
0USG0ZZ Reposition Vagina, Open Approach
0USG4ZZ Reposition Vagina, Percutaneous Endoscopic Approach
0USGXZZ Reposition Vagina, External Approach
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ICD‐9Code ICD‐9 Description ICD‐10 PCS
Code ICD‐10 PCS Description
70.78 Vaginal suspension and fixation with graft or prosthesis
0UUG07Z Supplement Vagina with Autol Sub, Open Approach
0UUG0JZ Supplement Vagina with Synthetic Substitute, Open Approach
0UUG0KZ Supplement Vagina with Nonaut Sub, Open Approach
0UUG47Z Supplement Vagina with Autol Sub, Perc Endo Approach
0UUG4JZ Supplement Vagina with Synth Sub, Perc Endo Approach
0UUG4KZ Supplement Vagina with Nonaut Sub, Perc Endo Approach
0UUG77Z Supplement Vagina with Autol Sub, Via Opening
0UUG7JZ Supplement Vagina with Synthetic Substitute, Via Opening
0UUG7KZ Supplement Vagina with Nonaut Sub, Via Opening
0UUG87Z Supplement Vagina with Autologous Tissue Substitute, Endo
0UUG8JZ Supplement Vagina with Synthetic Substitute, Endo
0UUG8KZSupplement Vagina with Nonautologous Tissue Substitute, Via Natural or Artificial Opening Endoscopic
70.95 Insertion of synthetic graft or prosthesis
0UUG0JZ Supplement Vagina with Synthetic Substitute, Open Approach
0UUG7JZ Supplement Vagina with Synthetic Substitute, Via Opening
0UUG8JZ Supplement Vagina with Synthetic Substitute, Endo
0UUG4JZ Supplement Vagina with Synth Sub, Perc Endo Approach
0UUGXJZ Supplement Vagina with Synthetic Subsitute, External Approach
0UUF0JZ Supplement Cul-de-sac with Synthetic Subsitute, Open Approach
0UUF4JZSupplement Cul-de-sac with Synthetic Subsitute, Percutaneous Endoscopic Approach
0UUF8JZSupplement Cul-de-sac with Synthetic Subsitute, Via Natural or Artificial Opening Endoscopic
0UUF7JZSupplement Cul-de-sac with Synthetic Subsitute, Via Natural or Artificial Opening