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The procedure described by CPT® Code 64714 refers to neuroplasty of a major peripheral nerve, specifically targeting the lumbar plexus, which is a critical network of nerves formed from the L1 to L4 nerve roots. This plexus is responsible for transmitting signals to various regions, including the back, abdomen, groin, thighs, knees, and calves. Injuries to the lumbar plexus can arise from various causes, such as blunt force trauma commonly seen in contact sports, automobile accidents, or falls. Additionally, conditions such as inflammation or the presence of tumors can lead to nerve damage. Such injuries or pathological processes may result in the formation of scar tissue and adhesions, which can entrap and compress the nerves within the lumbar plexus, leading to significant pain and functional impairment. The neuroplasty procedure involves making an incision in the lower back over the affected area, allowing for the division of soft tissues to expose the lumbar plexus. During the procedure, electrophysiological tests may be conducted to evaluate the function of the exposed nerves and nerve roots, helping to identify which nerves are under compression. The surgeon then meticulously dissects the compressed nerves free from the surrounding scar tissue and other obstructive structures. Once the affected nerves are adequately liberated, the soft tissues are carefully closed in layers to promote healing and restore function.
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The neuroplasty procedure indicated by CPT® Code 64714 is performed for specific conditions affecting the lumbar plexus. These indications include:
The neuroplasty procedure involves several critical steps to ensure the effective treatment of compressed nerves within the lumbar plexus. These steps include:
Post-procedure care following neuroplasty of the lumbar plexus involves monitoring the patient for any complications and ensuring proper recovery. Patients may experience some discomfort at the incision site, which can be managed with appropriate pain relief measures. Rehabilitation may be recommended to restore strength and function in the affected areas. Follow-up appointments are essential to assess the success of the procedure and to monitor nerve recovery. Patients should be advised on activity restrictions and signs of complications, such as increased pain, swelling, or signs of infection, that warrant immediate medical attention.
| Short Descr | REVISE LOW BACK NERVE(S) | Medium Descr | NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS | Long Descr | Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 6 - Decompression peripheral nerve |
This is a primary code that can be used with these additional add-on codes.
| 64727 | Addon Code MPFS Status: Active Code APC N ASC N1 PUB 100 CPT Assistant Article Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 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). | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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). | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 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). | 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 |
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| 2021-01-01 | Note | Guidelines changed. |
| 2011-01-01 | Changed | Long description revised. Medium description changed. |
| Pre-1990 | Added | Code added. |
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