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  6. 04130J4
  • Version 2025
  • Billable Code

2025 ICD-10-CM Procedure Code 04130J4

Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Open Approach

ICD-10-PCS Code:
04130J4
ICD-10-PCS Code for:
Bypass Hepatic Art to L Renal A w Synth Sub, Open
Is Billable?
Yes - Valid for Submission
Code Navigator:

04130J4 is a billable procedure code used to specify the performance of bypass hepatic artery to left renal artery with synthetic substitute, open approach. The code is valid for the year 2025 for the submission of HIPAA-covered transactions. The procedure code involves altering the route of passage of the contents of a tubular body part. Procedure code explanation: 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 coronary artery bypass, colostomy formation

04130J4 PCS Table

In an PCS table each code is represented by up seven alphanumeric characters, with each character in the table respresenting different aspects of the procedure. In the table provided below, each row represents an individual character and includes information about the character's position, designation, label, and procedure notes. For this PCS table the procedure code is in the medical and surgical section and is part of the lower arteries body system, classified under bypass operation. The applicable bodypart for this procedure code is hepatic artery.

Position Designation Character Label Procedures Notes
1 Section 0 Medical and Surgical
2 Body System 4 Lower Arteries
3 Operation 1 Bypass

Involves:
Altering the route of passage of the contents of a tubular body part

Explanation:
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

Includes:
  • Coronary artery bypass, colostomy formation
4 BodyPart 3 Hepatic Artery Includes:
  • Common hepatic artery
  • Gastroduodenal artery
  • Hepatic artery proper
5 Approach 0 Open

Involves:
Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure
6 Device J Synthetic Substitute Includes:
  • AbioCor(R) Total Replacement Heart
  • AMPLATZER(R) Muscular VSD Occluder
  • Annuloplasty ring
  • Bard(R) Composix(R) (E/X)(LP) mesh
  • Bard(R) Composix(R) Kugel(R) patch
  • Bard(R) Dulex(tm) mesh
  • Bard(R) Ventralex(tm) hernia patch
  • Barricaid(R) Annular Closure Device (ACD)
  • BRYAN(R) Cervical Disc System
  • Corvia IASD(R)
  • Ex-PRESS(tm) mini glaucoma shunt
  • Flexible Composite Mesh
  • GORE(R) DUALMESH(R)
  • Holter valve ventricular shunt
  • IASD(R) (InterAtrial Shunt Device), Corvia
  • InterAtrial Shunt Device IASD(R), Corvia
  • LimFlow(tm) Transcatheter Arterialization of the Deep Veins (TADV) System
  • MitraClip valve repair system
  • Nitinol framed polymer mesh
  • Open Pivot (mechanical) valve
  • Open Pivot Aortic Valve Graft (AVG)
  • Partially absorbable mesh
  • PHYSIOMESH(tm) Flexible Composite Mesh
  • Polymethylmethacrylate (PMMA)
  • Polypropylene mesh
  • PRESTIGE(R) Cervical Disc
  • PROCEED(tm) Ventral Patch
  • Prodisc-C
  • Prodisc-L
  • PROLENE Polypropylene Hernia System (PHS)
  • Rebound HRD(R) (Hernia Repair Device)
  • SynCardia Total Artificial Heart
  • Total artificial (replacement) heart
  • ULTRAPRO Hernia System (UHS)
  • ULTRAPRO Partially Absorbable Lightweight Mesh
  • ULTRAPRO Plug
  • V-Wave Interatrial Shunt System
  • Ventrio(tm) Hernia Patch
  • Zimmer(R) NexGen(R) LPS Mobile Bearing Knee
  • Zimmer(R) NexGen(R) LPS-Flex Mobile Knee
7 Qualifier 4 Renal Artery, Left

Replacement Code

04130J4 replaces the following previously assigned ICD-10-PCS code(s):

  • 04100J4 - Bypass Abd Aorta to L Renal A with Synth Sub, Open Approach
  • 04100J4 - Bypass Abd Aorta to L Renal A with Synth Sub, Open Approach
  • 04100J4 - Bypass Abd Aorta to L Renal A with Synth Sub, Open Approach
  • 04100J4 - Bypass Abd Aorta to L Renal A with Synth Sub, Open Approach
  • 04100J4 - Bypass Abd Aorta to L Renal A with Synth Sub, Open Approach
  • 04100J4 - Bypass Abd Aorta to L Renal A with Synth Sub, Open Approach

Clinical Classification

Peripheral arterial bypass procedures

CCSR Code: CAR014

Clinical Domain: Cardiovascular Procedures CAR contains 29 categories that include cardiovascular procedures such as percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and aneurysm repair procedures.

Convert to ICD-9-PCS

Below are the ICD-9=PCS code(s) that most closely match this ICD-10-PCS code, based on the General Equivalence Mappings (GEMs). This ICD-10-PCS to ICD-9-PCS crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

ICD-9-PCS Code

Code: 3926

Approximate Flag: This is an approximate match. The ICD-9-PCS code reflects a close but not exact equivalent of the ICD-10-PCS procedure.

Other ICD-10-PCS Codes Used for Bypass Hepatic Artery


  • 0413093 Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Open Approach
  • 0413094 Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Open Approach
  • 0413095 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach
  • 041309R Bypass Hepatic Artery to Lower Artery with Autologous Venous Tissue, Open Approach
  • 04130A3 Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04130A4 Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04130A5 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach
  • 04130AR Bypass Hepatic Artery to Lower Artery with Autologous Arterial Tissue, Open Approach
  • 04130J3 Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Open Approach
  • 04130J5 Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach
  • 04130JR Bypass Hepatic Artery to Lower Artery with Synthetic Substitute, Open Approach
  • 04130K3 Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130K4 Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130K5 Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130KR Bypass Hepatic Artery to Lower Artery with Nonautologous Tissue Substitute, Open Approach
  • 04130Z3 Bypass Hepatic Artery to Right Renal Artery, Open Approach
  • 04130Z4 Bypass Hepatic Artery to Left Renal Artery, Open Approach
  • 04130Z5 Bypass Hepatic Artery to Bilateral Renal Artery, Open Approach
  • 04130ZR Bypass Hepatic Artery to Lower Artery, Open Approach
  • 0413493 Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 0413494 Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 0413495 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 041349R Bypass Hepatic Artery to Lower Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
  • 04134A3 Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134A4 Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134A5 Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134AR Bypass Hepatic Artery to Lower Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
  • 04134J3 Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134J4 Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134J5 Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134JR Bypass Hepatic Artery to Lower Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
  • 04134K3 Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134K4 Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134K5 Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134KR Bypass Hepatic Artery to Lower Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
  • 04134Z3 Bypass Hepatic Artery to Right Renal Artery, Percutaneous Endoscopic Approach
  • 04134Z4 Bypass Hepatic Artery to Left Renal Artery, Percutaneous Endoscopic Approach
  • 04134Z5 Bypass Hepatic Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach
  • 04134ZR Bypass Hepatic Artery to Lower Artery, Percutaneous Endoscopic Approach

What is ICD-10-PCS?

The ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates. The 2025 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2024 through September 30, 2025.

Each ICD-10-PCS code has a structure of seven alphanumeric characters and contains no decimals. The first character defines the major "section". Depending on the "section" the second through seventh characters mean different things.