CPT® Code 64680

The celiac plexus is a complex network of nerves located in the retroperitoneum of the upper abdomen, specifically at the level of the T12-L1 vertebrae, situated anterior to the crura of the diaphragm. This plexus encircles critical vascular structures, including the abdominal aorta, celiac artery, and superior mesenteric artery. The procedure coded as CPT® 64680 involves the destruction of the celiac plexus using a neurolytic agent, which can be administered with or without the aid of radiologic monitoring. The primary purpose of this intervention is to alleviate pain associated with metastatic cancer, as well as to manage nonmalignant pain conditions, such as those arising from acute and chronic pancreatitis. The destruction of the celiac plexus can be achieved through various techniques, including the injection of a chemical neurolytic agent or the application of thermal, electrical, or radiofrequency methods. When radiologic monitoring is utilized, precise needle placement is confirmed through imaging, ensuring that the neurolytic agent is accurately delivered to the targeted nerve structures. This procedure is significant in pain management, providing relief to patients suffering from debilitating abdominal pain.