CCSD code L5300 – Open operations on iliac artery

Key takeaways

CCSD code L5300 is the general code for open operations on the iliac artery that no more specific CCSD code describes.

Bypass grafting and iliac endarterectomy have their own codes, L5100, L5180 and L5210, so check those before you reach for L5300.

Endovascular iliac work, such as angioplasty or stenting, is coded L5400, transluminal operations on iliac artery.

Pair L5300 with an iliac-level WHO ICD-10 diagnosis, such as I70.2, I72.3, I74.5 or S35.5.

Most UK insurers expect pre-authorisation for planned surgery, so record the authorisation code before the operation.

CCSD code L5300: Definition and clinical scope

CCSD code L5300 is the procedure code for open operations on iliac artery. It is the general code for an open iliac artery operation that no more specific CCSD code describes. The CCSD Group’s schedule holds the standard procedure codes for UK private healthcare, and it files L5300 under 9.5.0 Ileo-femoral Vessels.

That general role decides how the code is used. Bypass grafting and iliac endarterectomy each carry their own codes in the same section, and endovascular iliac work is L5400. L5300 is the code you reach for once those have been ruled out.

Bupa, AXA Health, Aviva, Vitality, WPA and other UK private medical insurers work from CCSD codes. Our guide to Bupa CCSD codes explains how the schedule works, and our CCSD procedure codes library collects the individual code guides. Practitioners send their bills electronically through Healthcode. Fee levels, pre-authorisation rules and multiple-code policies vary by insurer.

• Code type: CCSD procedure code
• Official descriptor: Open operations on iliac artery
• CCSD reference: FI.033
• Chapter: 9.0.0 Vascular System, section 9.5.0 Ileo-femoral Vessels
• Role: the general code for open iliac artery operations that have no more specific code
• Endovascular counterpart: L5400, transluminal operations on iliac artery
• Closest OPCS-4 category: L53, other open operations on iliac artery, which is also a residual category
• Common ICD-10 pairings: I70.2, I72.3, I74.5 and S35.5 (WHO ICD-10)

When L5300 applies: Check the named codes first

L5300 works as the fallback for open iliac surgery. Before you code it, check the operation against the named codes in section 9.5.0 and the wider vascular chapter. Work through the signed operative note in this order:

1. Catheter or sheath access only? The code is L5400, transluminal operations on iliac artery.
2. A bypass graft placed? Aorto-iliac, aorto-femoral and ilio-femoral bypass is L5100. Aorto-bifemoral bypass is L5180.
3. Plaque removed and the iliac artery patched? That is L5210, endarterectomy and patch repair of iliac artery.
4. An open embolectomy? L7010, open embolectomy of artery, covers it in section 9.6.0 Non-Specific.
5. The aorta the main target? Open aortic aneurysm grafts sit in 9.4.0 Abdominal Vessels, as L1940 and L1960.
6. None of the above? The open iliac operation falls to L5300.

Each yes ends the check at a named code. Only an open iliac operation that clears all five questions lands on L5300.

Operations that can fall under L5300

Typical examples, each assuming no named code describes the operation better:

• Open repair of an isolated iliac artery aneurysm, such as an interposition graft, where no bypass code fits.
• Open repair or ligation of an injured iliac artery after trauma.
• Open surgery after a failed iliac stent, such as removal of the stent and repair of the artery.
• Other open iliac operations that no named CCSD code describes, backed by a clear operative note.

Why L5300 is not added to a named code

The CCSD Technical Guide (October 2025) sets a single code principle. One code should usually describe the whole procedure, including pre-operative assessment, anaesthesia and post-operative care.

The same guide treats two therapeutic codes for the same organ as an inappropriate combination. It does the same for an open and a percutaneous code on the same organ. L5300 alongside L5100, L5210 or L5400 for the same artery is therefore a combination to avoid, unless the insurer confirms otherwise.

Clinical indications for open iliac artery surgery

Surgeons choose an open iliac operation when disease or injury cannot be treated safely or durably from inside the vessel. Failed endovascular treatment is the other common route to open surgery. The indication also steers the code, because several indications usually lead to a named procedure.

• Aortoiliac occlusive disease (Leriche syndrome): Stenosis or occlusion of the aortic bifurcation and iliac arteries, causing claudication, rest pain or critical limb ischaemia. Open treatment is usually a bypass, coded L5100 or L5180, or endarterectomy and patch repair, coded L5210.
• Isolated iliac artery aneurysm: An aneurysm that needs repair where the anatomy rules out endovascular exclusion. An open repair with no bypass code is where L5300 applies most directly.
• Iliac artery trauma: Penetrating or blunt injury that needs open haemorrhage control, ligation or repair.
• Failed endovascular treatment: Stent occlusion, restenosis or stent fracture that needs open surgery. Record the earlier procedure and the reason for conversion in the operative note.
• Acute embolic or thrombotic occlusion: An open embolectomy is coded L7010, not L5300. Check what the operative note says was done before you choose the code.

Open vs endovascular iliac procedures: L5300 or L5400

The approach decides between the two codes. An open incision on the iliac artery points to L5300 or a named open code. Catheter-based iliac work is L5400, transluminal operations on iliac artery.

When an endovascular procedure converts to open surgery, code from the final signed operative note and record why the approach changed. The Technical Guide treats an open and a percutaneous code for the same organ as an inappropriate combination. Ask the insurer before you bill L5400 alongside the open code.

Adjacent CCSD codes: Check these before L5300

Each code below is listed in the CCSD schedule, and each covers an operation that belongs on its own code. Seven of them sit in the same section as L5300, 9.5.0 Ileo-femoral Vessels.

Where the operation stays in the groin, below the inguinal ligament, the femoral codes apply instead. An endarterectomy confined to the femoral artery is L6000, and a crossover graft between the femoral arteries is L5910. Reopening an earlier femoral bypass graft to revise it falls under code L6530.

Renal artery operations sit in a separate section, 9.3.0 Renal, so they never fall under L5300. Endarterectomy of the renal artery, for example, is billed as L4140. Diagnostic angiography on its own is not an open iliac operation either.

ICD-10 diagnosis codes to pair with L5300

UK insurers expect a diagnosis from the WHO ICD-10 classification, not the US ICD-10-CM. The diagnosis should name the iliac artery, or the disease that affects it.

Code to the vessel and the pathology wherever you can. An unspecified diagnosis such as I73.9 does not confirm that the iliac artery was the diseased vessel, so it invites a query.

Documentation requirements for L5300 claims

Because L5300 is a general code, the operative note must confirm an open operation on the iliac artery. It must also make clear why no named code fits.

The operative note should include:

• Approach: An explicit statement of open access, such as midline laparotomy, retroperitoneal or groin incision.
• Vessel: The iliac segment operated on, whether the common, external or internal iliac artery.
• Laterality: Right, left or both sides. Ask the insurer how it wants a bilateral operation billed.
• Technique: What was done, in enough detail to rule out bypass, endarterectomy and patch repair, embolectomy and transluminal work.
• Indication: The clinical reason for surgery, matching the ICD-10 code on the bill.
• Graft or patch material: Prosthetic or vein, where used, because insurers handle implant charges differently.
• Conversion: If the case began as an endovascular procedure, the reason the approach changed.
• Completion imaging: Angiogram or duplex findings, where performed.

A digital operative note with required fields captures these details at the point of care. In Pabau, the practice software we build for private healthcare, a vascular team can build that note as a form with required fields. The patient record then holds the note, so an audit request is answered from one place.

Pre-authorisation: What private insurers require before L5300

Most UK private medical insurers expect pre-authorisation before planned open iliac artery surgery. Requirements differ by insurer and policy, so confirm them before you schedule the operation. Treatment carried out without a required authorisation may be paid at a reduced rate, or not at all.

Standard pre-authorisation evidence for L5300 typically includes:

• A written referral from the patient’s GP or referring physician.
• Imaging evidence of iliac artery disease, such as a CT angiography, MR angiography or duplex ultrasound report.
• A record that conservative treatment or endovascular options were considered or tried.
• The planned CCSD procedure code and the supporting ICD-10 diagnosis code.
• A supporting letter or clinical summary from the surgeon, where the insurer asks for one.

Insurer notes:

• Bupa: Bupa generally asks members to pre-authorise planned in-patient treatment. The Bupa code search portal shows how Bupa lists L5300 before you submit.
• AXA Health: Pre-authorisation is usually needed for planned surgical admissions. Put the authorisation number on the invoice you send through Healthcode.
• Aviva: Check the Aviva fee schedule for the current L5300 entry and any pre-authorisation note.
• Vitality, WPA, Cigna UK and Healix: Requirements and fees vary by policy. Contact the insurer’s provider line or portal before you proceed.

Reviewing the Bupa private fee schedule alongside your coding workflow keeps insurer rules current as schedules change.

Billing L5300 with anaesthesia and assistant surgeon fees

Under the CCSD single code principle, L5300 describes the whole operation, including the anaesthetic. The anaesthetist and any separately employed assistant still bill the insurer for their own fees. Each bill should reference the same procedure, date and authorisation number.

Every party should quote the same pre-authorisation number on their Healthcode bill. A mismatch between the surgeon’s and the anaesthetist’s bills is an avoidable reason for a rejection.

Common claim denials for L5300 and how to prevent them

L5300 claims are queried for a small set of recurring reasons. Each one is easier to fix before submission than on appeal.

How to record and submit L5300 claims

A fixed order of steps keeps L5300 claims consistent. The steps below suit UK private vascular practices billing insurers through Healthcode.

1. Record the diagnosis at the point of care. Enter the WHO ICD-10 code, such as I72.3, before you close the case.
2. Check the named codes first. Rule out L5100, L5180, L5210, L5400 and L7010 against the signed operative note.
3. Enter L5300 as the procedure code. Confirm the descriptor reads open operations on iliac artery.
4. Record the authorisation number. Enter the insurer’s pre-authorisation reference on the bill.
5. Submit through Healthcode. Send the bill electronically and keep the submission confirmation.
6. Reconcile the payment. Match the insurer’s remittance to the bill and invoice the patient for any agreed shortfall.

How Pabau keeps L5300 claims in order

A private vascular case produces an authorisation, an operative note and bills from several clinicians. Each of them has to quote the same details, and a missing authorisation code is enough to stop payment.

Pabau tracks the authorisation code, its dates and its sessions on the patient’s case, and shows a warning when the code is missing. Pabau’s claims management software then sends UK insurer claims through Healthcode and Bupa from the same record.

Your billing team works from the record the surgeon wrote, so the authorisation is on file before the claim goes out.

Keep authorisations and claims on one record

Pabau tracks the authorisation code on each case and warns you when one is missing. It sends UK insurer claims through Healthcode and Bupa from the same record.

Book a demo

Conclusion

L5300 is a narrow code with a wide name. It covers open iliac artery operations that no named CCSD code describes, and it gives way whenever a named code fits.

Bypass, endarterectomy and patch repair, embolectomy and endovascular work all have codes of their own. Check those first, then let the operative note show why L5300 was the right choice. A note that does that, with the authorisation code on file, is what keeps an open iliac claim paid.

To see how Pabau keeps the authorisation and the claim on one record, book a demo.

Continue your research

Need a full Bupa CCSD code reference? Bupa CCSD codes explains how the schedule works across UK private healthcare billing.

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Looking up another UK private insurance code? The CCSD codes library lists every code guide we publish for UK private practice.

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