General Surgery Coding Alert
Inventory Steps for Arcuate Ligament Syndrome
Question: The surgeon performed an open celiac artery dissection with lysis of the arcuate ligament for a patient with entrapment of the celiac artery and arcuate ligament syndrome. What are the correct diagnosis and procedure codes for this case? Vermont Subscriber Answer: Because CPT does not provide codes that specifically describe treatment for arcuate ligament syndrome or lysis of the arcuate ligament, recommending coding is difficult without seeing the actual operative report. That said, with the information available, we know that, typically, arcuate ligament syndrome includes compression of both the celiac artery and the celiac ganglia. Consider listing 35761 (Exploration [not followed by surgical repair], with or without lysis of artery; other vessels) for the decompression of the celiac artery. Additionally, if it appears that the lysis of the arcuate ligament was primarily intended to decompress the celiac ganglia, consider adding 64722 (Decompression; unspecified nerve[s] [specify]). The diagnosis code should be 447.4 (Celiac artery compression syndrome).
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