This is NOT my area of expertise, but I agree with 21705. I don't see any evidence to support 21556. And I'm not certain that he removed the entire 1st rib.
Here's the lay description from Encoder Pro ...
21705 - Division of scalenus anticus; with resection of cervical rib
The physician performs a surgical procedure where the scalenus anticus muscle is divided, usually for the purpose of treating thoracic outlet syndrome. With the patient under anesthesia, the physician makes an incision overlying the scalene muscle. This incision is carried deep to the muscle. The muscle is exposed and identified. A discission of the muscle is performed in line of the fibers. This relieves the pressure on the neurovascular structures. The wound is irrigated and closed in layers. Report 21700 if the procedure does not include resection of the cervical rib. Report 21705 if resection of the cervical rib is performed during the procedure.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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