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Official Description

Ligation; external carotid artery

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 37600 refers to the ligation of the external carotid artery, which is a surgical intervention aimed at occluding this major artery. The external carotid artery is responsible for supplying blood to various structures in the head and neck, including the face and scalp. Ligation of this artery may be indicated in several clinical scenarios, such as penetrating trauma that compromises the integrity of the artery, infections that may lead to severe complications, thrombosis that obstructs blood flow, or significant hemorrhage from nasal or other sources. Additionally, this procedure may be necessary in cases of tumor invasion or vascular malformations that pose a risk to the patient’s health. The surgical technique involves making a longitudinal incision through the skin and soft tissue to access the artery, which is then carefully exposed. Once the external carotid artery is identified, it is tied off, or ligated, using a suture or thin wire to prevent blood flow, thereby addressing the underlying medical issue.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Indications for performing the ligation of the external carotid artery include the following:

  • PENETRATING TRAUMA The procedure may be necessary in cases of penetrating injuries that damage the external carotid artery, leading to potential life-threatening hemorrhage.
  • INFECTION Infections that affect the artery can necessitate ligation to prevent further complications and control bleeding.
  • THROMBOSIS The presence of a thrombus can obstruct blood flow, and ligation may be required to manage the condition effectively.
  • SEVERE NASAL OR OTHER HEMORRHAGE Significant bleeding from the nasal cavity or other areas may require ligation to control the source of hemorrhage.
  • TUMOR INVASION Tumors that invade the external carotid artery may necessitate ligation to manage the tumor and prevent further vascular complications.
  • VASCULAR MALFORMATION Abnormal blood vessel formations may require ligation to reduce the risk of bleeding and other associated complications.

2. Procedure

The procedure for ligation of the external carotid artery involves several critical steps:

  • STEP 1: INCISION A longitudinal incision is made through the skin and soft tissue in the area where the external carotid artery is located. This incision allows for direct access to the artery and surrounding structures.
  • STEP 2: EXPOSURE OF THE ARTERY Once the incision is made, the surgeon carefully dissects through the soft tissue to expose the external carotid artery. This step requires precision to avoid damaging nearby structures.
  • STEP 3: LIGATION OF THE ARTERY After the artery is fully exposed, the surgeon ties off the external carotid artery using a suture or thin wire. This ligation effectively occludes the artery, preventing blood flow and addressing the underlying medical issue.

3. Post-Procedure

Post-procedure care following the ligation of the external carotid artery typically involves monitoring the patient for any signs of complications, such as bleeding or infection at the incision site. Patients may require pain management and should be advised on activity restrictions to promote healing. Follow-up appointments may be necessary to assess recovery and ensure that the ligation has effectively addressed the initial indications for the procedure. Additionally, any underlying conditions that led to the need for ligation should be managed appropriately to prevent recurrence.

Short Descr LIGATION XTRNL CAROTID ART
Medium Descr LIGATION EXTERNAL CAROTID ARTERY
Long Descr Ligation; external carotid artery
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
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) 1 - Co-surgeons could be paid, though supporting documentation is required...
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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 59 - Other OR procedures on vessels of head and neck
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).
GC This service has been performed in part by a resident under the direction of a teaching physician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
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
CR Catastrophe/disaster related
LT Left side (used to identify procedures performed on the left side of the body)
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
RT Right side (used to identify procedures performed on the right side of the body)
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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