04L03DJOcclusion of Abdominal Aorta with Intraluminal Device, Temporary, Percutaneous Approach
- Billable / Specific Code
04L03DJ is a billable ICD-10-PCS procedure code for Occlusion of Abdominal Aorta with Intraluminal Device, Temporary, Percutaneous Approach. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to 11 MS-DRGs. The root operation Occlusion involves completely closing an orifice or the lumen of a tubular body part. The Alphabetic Index lists this code under REBOA (resuscitative endovascular balloon occlusion of the aorta). In AHRQ's Clinical Classifications Software (CCSR), this procedure falls under Ligation and embolization of vessels.
Code Identity
PCS Table Breakdown
Each ICD-10-PCS code is built from seven characters, each an axis of the procedure. Hover or tap the icons for the official CMS definitions.
| Position | Designation | Value | Meaning |
|---|---|---|---|
| 1 | Section | 0 | Medical and Surgical |
| 2 | Body System | 4 | Lower Arteries |
| 3 | Operation | L | Occlusion |
| 4 | BodyPart | 0 | Abdominal Aorta |
| 5 | Approach | 3 | Percutaneous |
| 6 | Device | D | Intraluminal Device |
| 7 | Qualifier | J | Temporary |
In the ICD-10-PCS Alphabetic Index
The FY 2027 ICD-10-PCS Alphabetic Index refers to 04L03DJ as REBOA (resuscitative endovascular balloon occlusion of the aorta). These index entries lead to this code:
To code occlusion of the abdominal aorta, open the FY 2027 ICD-10-PCS Alphabetic Index at Occlusion, then the subterms Aorta, Abdominal. The index leads to table 04L, where the approach, device and qualifier values shown in the breakdown above complete the seven-character code 04L03DJ.
Clinical Classification (CCSR)
AHRQ groups this procedure code into these clinical categories.
Code History
- 04L00DJ — Occlusion Abd Aorta w Intralum Dev, Temp, Open
Similar Procedure Codes
Questions About 04L03DJ
Is 04L03DJ a billable code?
Yes. This is a complete seven-character ICD-10-PCS code, specific enough to report Occlusion of Abdominal Aorta with Intraluminal Device, Temporary, Percutaneous Approach on inpatient claims from October 1, 2026 through September 30, 2027.
What is the ICD-10-PCS code for REBOA (resuscitative endovascular balloon occlusion of the aorta)?
The ICD-10-PCS Alphabetic Index lists REBOA (resuscitative endovascular balloon occlusion of the aorta) under code 04L03DJ, Occlusion of Abdominal Aorta with Intraluminal Device, Temporary, Percutaneous Approach, billable on inpatient claims in fiscal year 2027.
What do the characters in 04L03DJ mean?
The code breaks down character by character: the 1st character 0 is the Section (Medical and Surgical); the 2nd character 4 is the Body System (Lower Arteries); the 3rd character L is the Operation (Occlusion); the 4th character 0 is the BodyPart (Abdominal Aorta); the 5th character 3 is the Approach (Percutaneous); the 6th character D is the Device (Intraluminal Device); the 7th character J is the Qualifier (Temporary).
What MS-DRG does 04L03DJ group to?
On an inpatient stay, Occlusion of Abdominal Aorta with Intraluminal Device, Temporary, Percutaneous Approach maps to MS-DRGs 268, 269, 356, 357, 358, 907, 908, 909, 957, 958, 959, with relative weights from 1.3810 to 7.5502. The MS-DRG sets the fixed Medicare payment for the stay.
