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

The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) code group 06R4 includes procedures performed to replace biological or synthetic material that takes the place and/or function of all or a portion of a body part in the hepatic vein. These ICD-10-PCS codes are used for inpatient documentation when a hepatic vein is removed and substituted with a graft or prosthetic conduit to restore venous continuity or function. Accurate coding within the ICD-10-PCS 06R4 group is essential for proper inpatient reimbursement, as it captures the replacement procedure performed and supports clinical documentation accuracy.

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Hepatic Vein Replacement Procedure Overview

This procedure group includes inpatient replacement of the hepatic vein and targets the lower veins body system. Procedures involve removing all or part of the hepatic vein and inserting biological or synthetic material to take the place and function of the vessel. Accurate coding of these replacement procedures is important for reflecting the complexity of care and for appropriate inpatient reimbursement. Correct ICD-10-PCS assignment supports clinical documentation and payment integrity.

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
0	Section	Medical and Surgical
6	Body System	Lower Veins
R	Operation	Replacement
4	Body Part	Hepatic Vein

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

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Hepatic Vein Replacement Procedure Overview

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
0	Section	Medical and Surgical
6	Body System	Lower Veins
R	Operation	Replacement
4	Body Part	Hepatic Vein

When to Use

Use these codes when the hepatic vein is replaced with biological or synthetic material during an inpatient encounter to restore or substitute venous structure or function. Do not use this group for repairs, revisions, or procedures that do not involve replacement of the hepatic vein.

ICD-10-PCS Codes

6 rows

ICD-10-PCS Code	Description
06R407Z	Replacement of Hepatic Vein with Autologous Tissue Substitute, Open Approach
06R40JZ	Replacement of Hepatic Vein with Synthetic Substitute, Open Approach
06R40KZ	Replacement of Hepatic Vein with Nonautologous Tissue Substitute, Open Approach
06R447Z	Replacement of Hepatic Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
06R44JZ	Replacement of Hepatic Vein with Synthetic Substitute, Percutaneous Endoscopic Approach
06R44KZ	Replacement of Hepatic Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

DRG Codes

3 rows

DRG Code	Description
270	Other Major Cardiovascular Procedures with MCC
271	Other Major Cardiovascular Procedures with CC
272	Other Major Cardiovascular Procedures without CC/MCC

Typical Clinical Scenarios

A 58-year-old patient presents to the emergency department with acute hepatic outflow obstruction after trauma to the right upper abdomen and imaging shows transection of a main hepatic vein with ongoing hemorrhage and compromised hepatic drainage. In the operating room, the damaged segment of the hepatic vein is excised and an autologous vein graft (patient's own saphenous vein) is used to re-establish venous continuity via an open approach to control bleeding and restore hepatic outflow. This inpatient procedure is performed urgently to prevent liver ischemia and ongoing blood loss. Typical codes: 06R407Z
A 45-year-old patient with chronic Budd-Chiari syndrome and progressive hepatic congestion undergoes a planned surgical reconstruction where a synthetic vascular conduit is used to replace a stenotic hepatic vein segment after failed endovascular therapy. The replacement is performed electively via an open abdominal approach to restore durable hepatic venous drainage and improve liver function. The inpatient stay is for postoperative monitoring and management of potential hepatic and hemodynamic complications. Typical codes: 06R40JZ
A 62-year-old patient with prior hepatic vein replacement using a biologic conduit presents with recurrent hepatic venous obstruction and graft degeneration months later, causing worsening ascites and liver enzyme abnormalities. During a percutaneous endoscopic procedure, the failed biologic conduit is removed and replaced with a nonautologous tissue graft (cryopreserved allograft) using a minimally invasive approach to re-establish venous outflow while minimizing operative trauma. The patient is admitted for observation and graft surveillance. Typical codes: 06R44KZ

Related Codes

06R0-INFERIOR-VENA-CAVA-REPLACEMENT

ICD-10-PCS Code For Inferior Vena Cava: Procedure Code Group Overview

06R1-SPLENIC-VEIN-REPLACEMENT

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

06R2-GASTRIC-VEIN-REPLACEMENT

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

06R3-ESOPHAGEAL-VEIN-REPLACEMENT

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

06R5-SUPERIOR-MESENTERIC-VEIN-REPLACEMENT

ICD-10-PCS Code For Superior Mesenteric Vein: Procedure Code Group Overview

06R6-INFERIOR-MESENTERIC-VEIN-REPLACEMENT

ICD-10-PCS Code For Inferior Mesenteric Vein: Procedure Code Group Overview

06R7-COLIC-VEIN-REPLACEMENT

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

06R8-PORTAL-VEIN-REPLACEMENT

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

06R9-RENAL-VEIN-RIGHT-REPLACEMENT

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

06RB-LEFT-RENAL-VEIN-REVISION-LEFT-RENAL-VEIN-REPLACEMENT

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

Showing 1–10 of 23

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
06R407Z	Replacement of Hepatic Vein with Autologous Tissue Substitute, Open Approach
06R40JZ	Replacement of Hepatic Vein with Synthetic Substitute, Open Approach
06R40KZ	Replacement of Hepatic Vein with Nonautologous Tissue Substitute, Open Approach
06R447Z	Replacement of Hepatic Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
06R44JZ	Replacement of Hepatic Vein with Synthetic Substitute, Percutaneous Endoscopic Approach
06R44KZ	Replacement of Hepatic Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

DRG Codes

3 rows

DRG Code	Description
270	Other Major Cardiovascular Procedures with MCC
271	Other Major Cardiovascular Procedures with CC
272	Other Major Cardiovascular Procedures without CC/MCC

Typical Clinical Scenarios

A 58-year-old patient presents to the emergency department with acute hepatic outflow obstruction after trauma to the right upper abdomen and imaging shows transection of a main hepatic vein with ongoing hemorrhage and compromised hepatic drainage. In the operating room, the damaged segment of the hepatic vein is excised and an autologous vein graft (patient's own saphenous vein) is used to re-establish venous continuity via an open approach to control bleeding and restore hepatic outflow. This inpatient procedure is performed urgently to prevent liver ischemia and ongoing blood loss. Typical codes: 06R407Z
A 45-year-old patient with chronic Budd-Chiari syndrome and progressive hepatic congestion undergoes a planned surgical reconstruction where a synthetic vascular conduit is used to replace a stenotic hepatic vein segment after failed endovascular therapy. The replacement is performed electively via an open abdominal approach to restore durable hepatic venous drainage and improve liver function. The inpatient stay is for postoperative monitoring and management of potential hepatic and hemodynamic complications. Typical codes: 06R40JZ
A 62-year-old patient with prior hepatic vein replacement using a biologic conduit presents with recurrent hepatic venous obstruction and graft degeneration months later, causing worsening ascites and liver enzyme abnormalities. During a percutaneous endoscopic procedure, the failed biologic conduit is removed and replaced with a nonautologous tissue graft (cryopreserved allograft) using a minimally invasive approach to re-establish venous outflow while minimizing operative trauma. The patient is admitted for observation and graft surveillance. Typical codes: 06R44KZ

Related Codes

06R0-INFERIOR-VENA-CAVA-REPLACEMENT

ICD-10-PCS Code For Inferior Vena Cava: Procedure Code Group Overview

06R1-SPLENIC-VEIN-REPLACEMENT

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

06R2-GASTRIC-VEIN-REPLACEMENT

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

06R3-ESOPHAGEAL-VEIN-REPLACEMENT

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

06R5-SUPERIOR-MESENTERIC-VEIN-REPLACEMENT

ICD-10-PCS Code For Superior Mesenteric Vein: Procedure Code Group Overview

06R6-INFERIOR-MESENTERIC-VEIN-REPLACEMENT

ICD-10-PCS Code For Inferior Mesenteric Vein: Procedure Code Group Overview

06R7-COLIC-VEIN-REPLACEMENT

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

06R8-PORTAL-VEIN-REPLACEMENT

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

06R9-RENAL-VEIN-RIGHT-REPLACEMENT

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

06RB-LEFT-RENAL-VEIN-REVISION-LEFT-RENAL-VEIN-REPLACEMENT

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

Showing 1–10 of 23

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 Hepatic Vein: Procedure Code Group Overview

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

Hepatic Vein Replacement Procedure Overview

Code Attributes

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

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

Hepatic Vein Replacement Procedure Overview

Code Attributes

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which procedures are included in the ICD-10-PCS 06R4 hepatic vein replacement group?

What are the specific ICD-10-PCS codes in this procedure group?

Which ICD-10-PCS section, body system, and operation apply to these codes?

How does accurate coding in the 06R4 group affect inpatient reimbursement?

What related DRGs might be assigned for hepatic vein replacement procedures?

References

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which procedures are included in the ICD-10-PCS 06R4 hepatic vein replacement group?

What are the specific ICD-10-PCS codes in this procedure group?

Which ICD-10-PCS section, body system, and operation apply to these codes?

How does accurate coding in the 06R4 group affect inpatient reimbursement?

What related DRGs might be assigned for hepatic vein replacement procedures?

References