CPT® Code 0882T

Add-On Code

1. Indications

Intraoperative therapeutic electrical stimulation of a peripheral nerve is indicated for several specific conditions and scenarios where nerve regeneration is necessary. The following are the primary indications for this procedure:

• Traumatic Nerve Injury This procedure is performed in cases of traumatic nerve injuries that may require nerve transfer to restore function.
• Digital Nerve Transection It is indicated when there is a complete transection of a digital nerve, necessitating intervention to promote healing and recovery.
• Nerve Decompression This procedure is also indicated for nerve decompression in conditions such as carpal tunnel syndrome and cubital tunnel syndrome, where pressure on the nerve needs to be alleviated.
• Facial Palsy In cases of facial palsy, electrical stimulation may be utilized to enhance nerve regeneration and improve functional outcomes.

2. Procedure

The procedure for intraoperative therapeutic electrical stimulation of a peripheral nerve involves several critical steps to ensure effective nerve regeneration. The following outlines the procedural steps:

• Step 1: Anesthesia Administration The patient is placed under general anesthesia to ensure comfort and immobility during the procedure. This is a crucial step as it allows the surgeon to operate without the patient experiencing pain or movement.
• Step 2: Surgical Access The surgeon gains access to the target peripheral nerve through a surgical incision. This step is essential for positioning the electrical stimulation device accurately on the nerve.
• Step 3: Lead Placement A handheld electrical stimulator with a specialized needle-like attachment is carefully positioned on the target peripheral nerve. This placement is critical to ensure that the electrical impulses are delivered directly to the nerve tissue.
• Step 4: Electrical Stimulation The electrical stimulation is then initiated, with a minimum duration of 10 minutes. This duration has been identified as optimal for enhancing nerve healing and regeneration. The stimulation activates the cAMP pathway, promoting axonal growth.
• Step 5: Lead Removal After the stimulation period, the lead is removed from the nerve. This step concludes the stimulation process, and the surgeon ensures that the nerve remains intact and undamaged.
• Step 6: Wound Closure Finally, the surgical site is closed using standard techniques, ensuring that the area is properly sutured to promote healing.

3. Post-Procedure

Post-procedure care for patients who have undergone intraoperative therapeutic electrical stimulation of a peripheral nerve includes monitoring for any immediate complications related to the surgery. Patients are typically observed in a recovery area until the effects of anesthesia wear off. It is essential to assess the surgical site for signs of infection or excessive swelling. Patients may experience some discomfort or pain at the site of the procedure, which can be managed with appropriate analgesics. Rehabilitation and physical therapy may be recommended to facilitate recovery and improve functional outcomes. The expected recovery time can vary based on the extent of the nerve injury and the individual patient's healing response. Follow-up appointments are crucial to monitor the progress of nerve regeneration and to adjust any rehabilitation strategies as needed.