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The procedure described by CPT® Code 21700 involves the surgical division of the scalenus anticus muscle, which is a muscle located in the neck. This procedure is performed to alleviate symptoms associated with thoracic outlet syndrome or cervical rib syndrome. Thoracic outlet syndrome occurs when there is compression of the brachial plexus, a network of nerves that control the arm and hand, often due to anatomical abnormalities such as the presence of a cervical rib or tightness of the scalenus anticus muscle. Cervical rib syndrome specifically refers to the compression caused by an additional rib that may develop from the seventh cervical vertebra. During the procedure, an incision is made above the clavicle to access the area. The surgeon exposes and incises the sternocleidomastoid muscle, which allows for better visibility and access to the scalenus anticus muscle. The scalenus anticus muscle is then divided, and any fibrous bands that may be compressing the brachial plexus are also cut and removed. If a cervical rib is present and contributing to the compression, further dissection is performed to reach the rib, which may be resected if it is determined to be exacerbating the condition. This procedure is critical for relieving nerve compression and improving symptoms related to these syndromes.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 21700 is indicated for the treatment of specific conditions that involve compression of the brachial plexus and associated structures. The following are the primary indications for performing this procedure:
The surgical procedure for CPT® Code 21700 involves several key steps that are performed to effectively address the compression of the brachial plexus. The following outlines the procedural steps:
After the completion of the procedure, patients may require specific post-operative care to ensure proper recovery. This may include monitoring for any complications, managing pain, and following up with physical therapy to restore function and mobility. The expected recovery time can vary based on individual patient factors and the extent of the procedure performed. Patients are typically advised to avoid strenuous activities during the initial recovery phase and to follow the surgeon's instructions regarding wound care and activity restrictions.
| Short Descr | REVISION OF NECK MUSCLE | Medium Descr | DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB | Long Descr | Division of scalenus anticus; without resection of cervical rib | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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