ICD-10-PCS Code `04104K5`

Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
“Bypass Abd Aorta to B Renal A w Nonaut Sub, Perc Endo” for short

Billable Code

04104K5 is a valid billable ICD-10 procedure code for Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach. It is found in the 2024 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024.

Bypass involves:
Altering the route of passage of the contents of a tubular body part. Rerouting contents of a body part to a downstream area of the normal route, to a similar route and body part, or to an abnormal route and dissimilar body part. Includes one or more anastomoses, with or without the use of a device

Percutaneous Endoscopic approach involves:
Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure

Bypass includes:

Coronary artery bypass, colostomy formation

Abdominal Aorta body part includes:

Inferior phrenic artery
Lumbar artery
Median sacral artery
Middle suprarenal artery
Ovarian artery
Testicular artery

Nonautologous Tissue Substitute device includes:

Acellular Hydrated Dermis
Bone bank bone graft
Cook Biodesign(R) Fistula Plug(s)
Cook Biodesign(R) Hernia Graft(s)
Cook Biodesign(R) Layered Graft(s)
Cook Zenapro(tm) Layered Graft(s)
MIRODERM(tm) Biologic Wound Matrix
Tissue bank graft

MS-DRG - Medicare Severity-Diagnosis Related Group

MDC 05 Diseases & Disorders of the Circulatory System
Aortic and Heart Assist Procedures
- DRG 268 - AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
- DRG 269 - AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
MDC 11 Diseases & Disorders of the Kidney & Urinary Tract
Kidney and Ureter Procedures
- DRG 656 - KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
- DRG 657 - KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
- DRG 658 - KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
- DRG 659 - KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
- DRG 660 - KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
- DRG 661 - KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
MDC 21 Injuries, Poisonings & Toxic Effects of Drugs
Other O.R. Procedures for Injuries
- DRG 907 - OTHER O.R. PROCEDURES FOR INJURIES WITH MCC
- DRG 908 - OTHER O.R. PROCEDURES FOR INJURIES WITH CC
- DRG 909 - OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC
MDC 24 Multiple Significant Trauma
Other Procedures for Multiple Significant Trauma
- DRG 957 - OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC
- DRG 958 - OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC
- DRG 959 - OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

ICD-10-PCS code structure for 04104K5 — See Table View

1: Section	`0`	Medical and Surgical
2: Body System	`4`	Lower Arteries
3: Root Operation	`1`	Bypass
4: Body Part	`0`	Abdominal Aorta
5: Approach	`4`	Percutaneous Endoscopic
6: Device	`K`	Nonautologous Tissue Substitute
7: Qualifier	`5`	Renal Artery, Bilateral

See also

The ICD-10-PCS Index of common procedure terms.
Medical and Surgical terms in the ICD-10-PCS Definitions table. These definitions may also provide additional explanation and/or examples within this section.
The ICD-10-PCS Device Aggregation Table containing entries that correlate a specific ICD-10-PCS device value with a general device value to be used in tables containing only general device values.

See similar ICD-10-PCS procedure code(s) with an alternate qualifier:

Nonautologous Tissue Substitute

04104K0 - Bypass Abdominal Aorta to Abdominal Aorta with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K1 - Bypass Abdominal Aorta to Celiac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K2 - Bypass Abdominal Aorta to Mesenteric Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K3 - Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K4 - Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K5 - Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach (current)
04104K6 - Bypass Abdominal Aorta to Right Common Iliac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K7 - Bypass Abdominal Aorta to Left Common Iliac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K8 - Bypass Abdominal Aorta to Bilateral Common Iliac Arteries with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K9 - Bypass Abdominal Aorta to Right Internal Iliac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KB - Bypass Abdominal Aorta to Left Internal Iliac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KC - Bypass Abdominal Aorta to Bilateral Internal Iliac Arteries with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KD - Bypass Abdominal Aorta to Right External Iliac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KF - Bypass Abdominal Aorta to Left External Iliac Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KG - Bypass Abdominal Aorta to Bilateral External Iliac Arteries with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KH - Bypass Abdominal Aorta to Right Femoral Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KJ - Bypass Abdominal Aorta to Left Femoral Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KK - Bypass Abdominal Aorta to Bilateral Femoral Arteries with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KQ - Bypass Abdominal Aorta to Lower Extremity Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104KR - Bypass Abdominal Aorta to Lower Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

ICD-10-PCS Code 04104K5

ICD-10-PCS Code `04104K5`