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ICD 10 Code 04RQ4KZ

Replacement of Left Anterior Tibial Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
“Replace of L Ant Tib Art with Nonaut Sub, Perc Endo Approach” for short

04RQ4KZ is a valid billable ICD-10 procedure code for Replacement of Left Anterior Tibial Artery with Nonautologous Tissue Substitute, 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.

Replacement involves:
Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part. The body part may have been taken out or replaced, or may be taken out, physically eradicated, or rendered nonfunctional during the Replacement procedure. A Removal procedure is coded for taking out the device used in a previous replacement procedure

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

Replacement includes:

  • Total hip replacement, bone graft, free skin graft

Anterior Tibial Artery, Left body part includes:

  • Anterior lateral malleolar artery
  • Anterior medial malleolar artery
  • Anterior tibial recurrent artery
  • Dorsalis pedis artery
  • Posterior tibial recurrent 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)
  • Fish skin
  • Kerecis(R) (GraftGuide) (MariGen) (SurgiBind) (SurgiClose)
  • MIRODERM(tm) Biologic Wound Matrix
  • Piscine skin
  • Tissue bank graft
MS-DRG - Medicare Severity-Diagnosis Related Group
  • MDC 05 Diseases & Disorders of the Circulatory System
    Other Vascular Procedures
    • DRG 252 - OTHER VASCULAR PROCEDURES WITH MCC
    • DRG 253 - OTHER VASCULAR PROCEDURES WITH CC
    • DRG 254 - OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
  • MDC 10 Endocrine, Nutritional & Metabolic Diseases & Disorders
    Other Endocrine, Nutritional and Metabolic Procedures
    • DRG 628 - OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC
    • DRG 629 - OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC
    • DRG 630 - OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC 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

ICD-10-PCS code structure for 04RQ4KZ — See Table View

1: Section 0 Medical and Surgical
2: Body System 4 Lower Arteries
3: Root Operation R Replacement
4: Body Part Q Anterior Tibial Artery, Left
5: Approach 4 Percutaneous Endoscopic
6: Device K Nonautologous Tissue Substitute
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.