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Transection or avulsion of the supraorbital nerve, as described by CPT® Code 64732, refers to a surgical procedure that involves the severing and/or removal of a portion of the supraorbital nerve. This procedure is primarily performed to alleviate chronic pain conditions. The supraorbital nerve is a significant branch of the frontal nerve, which is responsible for sensory innervation to specific areas of the forehead and upper eyelid. It exits the skull through the supraorbital foramen or groove, providing palpebral filaments that supply the upper eyelid and further divides into medial and lateral branches that innervate the scalp. The surgical approach typically involves making an incision over the eyebrow, followed by careful dissection of the soft tissues to expose the supraorbital nerve as it exits the foramen. The nerve is then isolated, and various techniques may be employed to transect or avulse it, which may include the use of a rongeur to enhance visibility and access. This procedure is indicated for patients suffering from conditions that warrant the interruption of nerve function to manage pain effectively.
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Transection or avulsion of the supraorbital nerve is indicated for the treatment of chronic pain conditions that may be associated with nerve dysfunction or irritation. This procedure is typically considered when conservative management strategies have failed to provide adequate relief. The specific indications for this procedure may include:
The procedure for transection or avulsion of the supraorbital nerve involves several key steps, which are detailed as follows:
Post-procedure care following transection or avulsion of the supraorbital nerve typically involves monitoring for any immediate complications, such as bleeding or infection. Patients may experience some degree of pain or discomfort at the incision site, which can be managed with appropriate analgesics. Recovery time may vary, but patients are generally advised to avoid strenuous activities for a specified period to allow for proper healing. Follow-up appointments may be scheduled to assess the surgical site and evaluate the effectiveness of the procedure in alleviating pain. Additionally, patients should be informed about potential changes in sensation in the forehead and scalp areas innervated by the supraorbital nerve.
| Short Descr | INCISION OF BROW NERVE | Medium Descr | TRANSECTION/AVULSION SUPRAORBITAL NERVE | Long Descr | Transection or avulsion of; supraorbital nerve | 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) | 0 - Co-surgeons not permitted for this procedure. | 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 | Surgical procedure on ASC list in CY 2007; 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 | 9 - Other OR therapeutic nervous system procedures |
| 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). | 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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) |
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