CPT® Code 0883T

Add-On Code

1. Indications

Intraoperative therapeutic electrical stimulation of peripheral nerves is indicated for several specific conditions and scenarios where nerve regeneration is critical. 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 for patients who have experienced transection of digital nerves, which can lead to loss of sensation and function in the fingers.
• Nerve Decompression The procedure is also indicated for nerve decompression in conditions such as carpal tunnel syndrome and cubital tunnel syndrome, where pressure on the nerve can impair function.
• Facial Palsy In cases of facial palsy, electrical stimulation may be utilized to promote nerve regeneration and improve facial function.

2. Procedure

The procedure for intraoperative therapeutic electrical stimulation of a peripheral nerve involves several key steps that 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 critical step as it allows for precise manipulation of the nerve without causing discomfort to the patient.
• Step 2: Identification of the Target Nerve The surgeon carefully identifies the target peripheral nerve that requires stimulation. This may involve dissection and exposure of the nerve to ensure accurate placement of the stimulation device.
• Step 3: Lead Placement A handheld electrical stimulator with a specialized needle-like attachment is used to place the lead onto the target nerve. This step is crucial as the correct positioning of the lead directly affects the efficacy of the electrical stimulation.
• Step 4: Electrical Stimulation Once the lead is securely placed, the electrical stimulation is initiated. The stimulation is delivered for a minimum of 10 minutes, which is the optimal duration for promoting nerve healing and regeneration.
• Step 5: Lead Removal After the stimulation period, the lead is carefully removed from the nerve. This step must be performed with precision to avoid any damage to the nerve or surrounding tissues.

3. Post-Procedure

Following the intraoperative therapeutic electrical stimulation, the patient will be monitored in the recovery area as the effects of anesthesia wear off. Post-procedure care may include pain management and monitoring for any signs of complications. The expected recovery period will vary depending on the extent of the nerve injury and the individual patient's healing response. Patients may require follow-up appointments to assess nerve function and recovery progress. It is essential to provide appropriate rehabilitation and therapy to support the recovery process and maximize functional outcomes.