1. Home
  2. ICD-10-PCS
  3. 04L54ZZ
  4. Share
  5. Feedback

ICD 10 Code 04L54ZZ

Occlusion of Superior Mesenteric Artery, Percutaneous Endoscopic Approach
“Occlusion of Superior Mesenteric Artery, Perc Endo Approach” for short

04L54ZZ is a valid billable ICD-10 procedure code for Occlusion of Superior Mesenteric Artery, Percutaneous Endoscopic Approach. It is found in the 2025 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2024 - Sep 30, 2025.

Occlusion involves:
Completely closing an orifice or the lumen of a tubular body part. The orifice can be a natural orifice or an artificially created orifice

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

Occlusion includes:

  • Fallopian tube ligation, ligation of inferior vena cava

Superior Mesenteric Artery body part includes:

  • Ileal artery
  • Ileocolic artery
  • Inferior pancreaticoduodenal artery
  • Jejunal artery
MS-DRG - Medicare Severity-Diagnosis Related Group
  • MDC 05 Diseases & Disorders of the Circulatory System
    Other Major Cardiovascular Procedures
    • DRG 270 - OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
    • DRG 271 - OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
    • DRG 272 - OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
  • MDC 06 Diseases & Disorders of the Digestive System
    Other Digestive System O.R. Procedures
    • DRG 356 - OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC
    • DRG 357 - OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC
    • DRG 358 - OTHER DIGESTIVE SYSTEM O.R. PROCEDURES 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
  • MDC 99 Other
    Non-extensive Procedure Unrelated to Principal Diagnosis
    • DRG 987 - NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
    • DRG 988 - NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
    • DRG 989 - NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

ICD-10-PCS code structure for 04L54ZZ — See Table View

1: Section 0 Medical and Surgical
2: Body System 4 Lower Arteries
3: Root Operation L Occlusion
4: Body Part 5 Superior Mesenteric Artery
5: Approach 4 Percutaneous Endoscopic
6: Device Z No Device
7: Qualifier Z No Qualifier

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.