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Official Description

Ligation, major artery (eg, post-traumatic, rupture); chest

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 37616 involves the ligation of a major artery located in the chest, typically performed in response to a traumatic injury or rupture of the blood vessel. Ligation is a surgical technique used to control bleeding by tying off the artery, thereby preventing further blood loss. In this procedure, the physician first makes an incision to access the site of injury, allowing for exploration of the affected area. During this exploration, any accumulated blood is evacuated, and the source of the bleeding is identified. A vascular clamp is then applied to temporarily control the bleeding, enabling the surgeon to thoroughly examine the site for any additional injuries that may require attention. Once the area is adequately assessed, the surgeon dissects the artery free from surrounding tissues, which is crucial for the safe placement of a suture ligature or wire band. The ligation is performed at a point proximal to the rupture, ensuring that blood flow beyond the injury is effectively halted. This procedure is critical in managing severe trauma cases where rapid control of hemorrhage is necessary to stabilize the patient. It is important to note that this code is specifically used when the ligation occurs in the chest; different codes are designated for ligation in other anatomical locations, such as the neck, abdomen, or extremities.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The ligation of a major artery in the chest, as described by CPT® Code 37616, is indicated in specific clinical scenarios where control of bleeding is necessary due to traumatic injuries. The following conditions may warrant this procedure:

  • Post-Traumatic Injury The procedure is performed following a traumatic event that has resulted in the rupture of a major artery in the chest, leading to significant hemorrhage.
  • Rupture of Blood Vessel Any instance where a major artery has ruptured, causing uncontrolled bleeding, necessitates immediate surgical intervention to prevent further blood loss and stabilize the patient.

2. Procedure

The procedure for ligation of a major artery in the chest involves several critical steps to ensure effective control of bleeding. The following outlines the procedural steps:

  • Step 1: Incision and Exploration The surgeon begins by making an incision at the site of the injury to gain access to the chest cavity. This incision allows for direct visualization and exploration of the affected area, which is essential for identifying the source of bleeding.
  • Step 2: Evacuation of Blood Once the incision is made, any pooled blood in the area is evacuated. This step is crucial as it helps to clear the surgical field, allowing the surgeon to accurately assess the extent of the injury and locate the ruptured artery.
  • Step 3: Application of Vascular Clamp A vascular clamp is then applied to the artery to temporarily control the bleeding. This clamp serves to occlude blood flow, providing a clearer view of the surgical site and facilitating further exploration for any additional injuries.
  • Step 4: Dissection of the Artery The surgeon carefully dissects the artery free from surrounding tissues. This dissection is performed with precision to avoid damaging adjacent structures and to prepare the artery for ligation.
  • Step 5: Ligation of the Artery Finally, the artery is tied off using sutures or a thin wire at a point proximal to the rupture. This step effectively halts blood flow beyond the site of injury, thereby controlling the hemorrhage and stabilizing the patient.

3. Post-Procedure

After the ligation procedure is completed, the patient will require careful monitoring for any signs of complications, such as infection or further bleeding. Post-operative care may include pain management, observation for vital signs, and ensuring that the surgical site is healing properly. The recovery process will vary depending on the extent of the injury and the overall health of the patient. Follow-up appointments may be necessary to assess the healing process and to address any potential complications that may arise following the surgery.

Short Descr LIGATION MAJOR ARTERY CHEST
Medium Descr LIGATION MAJOR ARTERY CHEST
Long Descr Ligation, major artery (eg, post-traumatic, rupture); chest
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 Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 61 - Other OR procedures on vessels other than 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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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
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)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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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