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ICD 10 Code 04L94CZ

Occlusion of Right Renal Artery with Extraluminal Device, Percutaneous Endoscopic Approach
“Occlusion R Renal Art w Extralum Dev, Perc Endo” for short

04L94CZ is a valid billable ICD-10 procedure code for Occlusion of Right Renal Artery with Extraluminal Device, 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

Renal Artery, Right body part includes:

  • Inferior suprarenal artery
  • Renal segmental artery

Extraluminal Device device includes:

  • AtriClip LAA Exclusion System
  • LAP-BAND(R) adjustable gastric banding system
  • REALIZE(R) Adjustable Gastric Band
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 11 Diseases & Disorders of the Kidney & Urinary Tract
    Other Kidney and Urinary Tract Procedures
    • DRG 673 - OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
    • DRG 674 - OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC
    • DRG 675 - OTHER KIDNEY AND URINARY TRACT 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 04L94CZ — See Table View

1: Section 0 Medical and Surgical
2: Body System 4 Lower Arteries
3: Root Operation L Occlusion
4: Body Part 9 Renal Artery, Right
5: Approach 4 Percutaneous Endoscopic
6: Device C Extraluminal 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.