ICD-10-PCS Code For Innominate Vein Left: Procedure Code Group Overview

The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) code group 05R4 includes procedures performed to replace biological or synthetic material that takes the place and/or function of all or a portion of the left innominate vein in the upper veins. These ICD-10-PCS codes are used for inpatient documentation when a surgeon removes and replaces a segment of the left innominate vein due to disease, injury, obstruction, or other pathology requiring vascular replacement. Accurate coding within the ICD-10-PCS 05R4 group is essential for proper inpatient reimbursement, as it captures the specific replacement procedure performed and supports clinical documentation accuracy.

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Innominate Vein, Left Replacement Procedure Overview

Procedures in this group involve replacement of the left innominate vein within the upper venous system, where biological or synthetic material physically takes the place and/or function of all or part of the vessel. These operations replace diseased, damaged, or obstructed segments of the left innominate vein to restore venous continuity and flow. Accurate ICD-10-PCS coding of these replacement procedures ensures proper inpatient documentation and supports appropriate case mix and reimbursement.

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
0	Section	Medical and Surgical
5	Body System	Upper Veins
R	Operation	Replacement
4	Body Part	Innominate Vein, Left

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ICD-10-PCS Code For Innominate Vein Left: Procedure Code Group Overview

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Innominate Vein, Left Replacement Procedure Overview

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
0	Section	Medical and Surgical
5	Body System	Upper Veins
R	Operation	Replacement
4	Body Part	Innominate Vein, Left

When to Use

Use codes from this group when the left innominate vein is surgically removed and a replacement conduit is implanted to restore venous continuity or function. Typical clinical circumstances include severe venous injury, thrombosis with irreversible damage, aneurysm, or other pathology requiring excision and replacement of the vein.

ICD-10-PCS Codes

6 rows

ICD-10-PCS Code	Description
05R407Z	Replacement of Left Innominate Vein with Autologous Tissue Substitute, Open Approach
05R40JZ	Replacement of Left Innominate Vein with Synthetic Substitute, Open Approach
05R40KZ	Replacement of Left Innominate Vein with Nonautologous Tissue Substitute, Open Approach
05R447Z	Replacement of Left Innominate Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
05R44JZ	Replacement of Left Innominate Vein with Synthetic Substitute, Percutaneous Endoscopic Approach
05R44KZ	Replacement of Left Innominate Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

DRG Codes

16 rows

DRG Code	Description
163	Major Chest Procedures with MCC
164	Major Chest Procedures with CC
165	Major Chest Procedures without CC/MCC
212	Concomitant Aortic and Mitral Valve Procedures
216	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC
217	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC
218	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC
219	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC
220	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC
221	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC

Showing 1–10 of 16

Typical Clinical Scenarios

An adult trauma patient sustains blunt chest and upper mediastinal injury after a high-speed motor vehicle collision with imaging and intraoperative findings of a lacerated left innominate vein causing ongoing hemorrhage and hemodynamic instability; emergent open surgical excision of the damaged segment with implantation of a conduit is performed to restore venous continuity and control bleeding. Typical codes: 05R407Z, 05R40JZ
An older patient with chronic left brachiocephalic vein thrombosis and post-thrombotic stenosis presenting with progressive left upper extremity swelling and failed endovascular recanalization is admitted for a planned operative replacement of the fibrotic left innominate vein segment using biologic or synthetic graft to reestablish central venous outflow. Typical codes: 05R44JZ, 05R447Z
A patient with prior central venous reconstruction develops prosthetic graft infection and persistent sepsis despite antibiotics; in the inpatient setting the infected left innominate vein conduit is removed and replaced with autologous tissue or a nonautologous biologic substitute during revision surgery to eradicate infection and restore venous drainage. Typical codes: 05R40KZ, 05R447Z

Related Codes

05R0-AZYGOS-VEIN-REPLACEMENT

ICD-10-PCS Code For Azygos Vein: Procedure Code Group Overview

05R1-HEMIAZYGOS-VEIN-REPLACEMENT

ICD-10-PCS Code For Hemiazygos Vein: Procedure Code Group Overview

05R3-INNOMINATE-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Innominate Vein Right: Procedure Code Group Overview

05R5-SUBCLAVIAN-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Subclavian Vein, Right: Procedure Code Group Overview

05R6-SUBCLAVIAN-VEIN-LEFT-REPLACEMENT

ICD-10-PCS Code For Subclavian Vein, Left: Procedure Code Group Overview

05R7-AXILLARY-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Axillary Vein, Right: Procedure Code Group Overview

05R8-LEFT-AXILLARY-VEIN-REPLACEMENT

ICD-10-PCS Code For Axillary Vein, Left: Procedure Code Group Overview

05R9-BRACHIAL-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Brachial Vein Right: Procedure Code Group Overview

05RA-LEFT-BRACHIAL-VEIN-REPLACEMENT

ICD-10-PCS Code For Brachial Vein, Left: Procedure Code Group Overview

05RB-BASILIC-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Basilic Vein Right: Procedure Code Group Overview

Showing 1–10 of 25

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-PCS Codes

6 rows

ICD-10-PCS Code	Description
05R407Z	Replacement of Left Innominate Vein with Autologous Tissue Substitute, Open Approach
05R40JZ	Replacement of Left Innominate Vein with Synthetic Substitute, Open Approach
05R40KZ	Replacement of Left Innominate Vein with Nonautologous Tissue Substitute, Open Approach
05R447Z	Replacement of Left Innominate Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
05R44JZ	Replacement of Left Innominate Vein with Synthetic Substitute, Percutaneous Endoscopic Approach
05R44KZ	Replacement of Left Innominate Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

DRG Codes

16 rows

DRG Code	Description
163	Major Chest Procedures with MCC
164	Major Chest Procedures with CC
165	Major Chest Procedures without CC/MCC
212	Concomitant Aortic and Mitral Valve Procedures
216	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC
217	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC
218	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC
219	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC
220	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC
221	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization without CC/MCC

Showing 1–10 of 16

Typical Clinical Scenarios

An adult trauma patient sustains blunt chest and upper mediastinal injury after a high-speed motor vehicle collision with imaging and intraoperative findings of a lacerated left innominate vein causing ongoing hemorrhage and hemodynamic instability; emergent open surgical excision of the damaged segment with implantation of a conduit is performed to restore venous continuity and control bleeding. Typical codes: 05R407Z, 05R40JZ
An older patient with chronic left brachiocephalic vein thrombosis and post-thrombotic stenosis presenting with progressive left upper extremity swelling and failed endovascular recanalization is admitted for a planned operative replacement of the fibrotic left innominate vein segment using biologic or synthetic graft to reestablish central venous outflow. Typical codes: 05R44JZ, 05R447Z
A patient with prior central venous reconstruction develops prosthetic graft infection and persistent sepsis despite antibiotics; in the inpatient setting the infected left innominate vein conduit is removed and replaced with autologous tissue or a nonautologous biologic substitute during revision surgery to eradicate infection and restore venous drainage. Typical codes: 05R40KZ, 05R447Z

Related Codes

05R0-AZYGOS-VEIN-REPLACEMENT

ICD-10-PCS Code For Azygos Vein: Procedure Code Group Overview

05R1-HEMIAZYGOS-VEIN-REPLACEMENT

ICD-10-PCS Code For Hemiazygos Vein: Procedure Code Group Overview

05R3-INNOMINATE-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Innominate Vein Right: Procedure Code Group Overview

05R5-SUBCLAVIAN-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Subclavian Vein, Right: Procedure Code Group Overview

05R6-SUBCLAVIAN-VEIN-LEFT-REPLACEMENT

ICD-10-PCS Code For Subclavian Vein, Left: Procedure Code Group Overview

05R7-AXILLARY-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Axillary Vein, Right: Procedure Code Group Overview

05R8-LEFT-AXILLARY-VEIN-REPLACEMENT

ICD-10-PCS Code For Axillary Vein, Left: Procedure Code Group Overview

05R9-BRACHIAL-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Brachial Vein Right: Procedure Code Group Overview

05RA-LEFT-BRACHIAL-VEIN-REPLACEMENT

ICD-10-PCS Code For Brachial Vein, Left: Procedure Code Group Overview

05RB-BASILIC-VEIN-RIGHT-REPLACEMENT

ICD-10-PCS Code For Basilic Vein Right: Procedure Code Group Overview

Showing 1–10 of 25

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-PCS Code For Innominate Vein Left: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Innominate Vein Left: Procedure Code Group Overview policy alerts

Innominate Vein, Left Replacement Procedure Overview

Code Attributes

ICD-10-PCS Code For Innominate Vein Left: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Innominate Vein Left: Procedure Code Group Overview policy alerts

Innominate Vein, Left Replacement Procedure Overview

Code Attributes

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-PCS codes are included in the Innominate Vein, Left replacement group?

What clinical scenario justifies using an ICD-10-PCS 05R4 code?

How do approach and substitute type affect code selection in 05R4?

Why is accurate coding within 05R4 important for hospitals?

Which DRG categories might be associated with procedures in the 05R4 group?

References

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-PCS codes are included in the Innominate Vein, Left replacement group?

What clinical scenario justifies using an ICD-10-PCS 05R4 code?

How do approach and substitute type affect code selection in 05R4?

Why is accurate coding within 05R4 important for hospitals?

Which DRG categories might be associated with procedures in the 05R4 group?

References