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Transection or avulsion of the lingual nerve is a surgical procedure that involves the severing and/or removal of a portion of the lingual nerve, which is a branch of the mandibular nerve. This procedure is primarily performed to alleviate chronic pain that may be associated with various conditions affecting the oral cavity. The lingual nerve is responsible for providing sensory innervation to the anterior two-thirds of the tongue and the lingual surface of the mandibular gingiva, making it a critical structure in oral sensation and function. During the procedure, an intraoral approach is utilized to access the nerve, allowing the surgeon to expose and isolate it effectively. The transection is typically carried out by grasping the nerve and dividing it at a proximal point, which may be followed by avulsion, where the nerve is twisted over a hemostat to remove it. Alternatively, the procedure may involve stretching the nerve, ligating it, and then dividing it first at the distal end before proceeding to the proximal end. This detailed approach ensures that the procedure is performed with precision, aiming to provide relief from chronic pain while minimizing potential complications.
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The procedure of transection or avulsion of the lingual nerve is indicated for specific conditions that result in chronic pain. The following are the explicitly provided indications for this surgical intervention:
The procedure of transection or avulsion of the lingual nerve involves several critical steps to ensure effective treatment. The following procedural steps are outlined:
After the transection or avulsion of the lingual nerve, post-procedure care is essential for optimal recovery. Patients may experience some discomfort and swelling in the area where the procedure was performed. It is important for healthcare providers to monitor the patient for any signs of complications, such as infection or excessive bleeding. Pain management strategies may be implemented to ensure patient comfort during the recovery period. Additionally, follow-up appointments should be scheduled to assess healing and address any concerns the patient may have regarding their recovery process.
| Short Descr | INCISION OF TONGUE NERVE | Medium Descr | TRANSECTION/AVULSION LINGUAL NERVE | Long Descr | Transection or avulsion of; lingual 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). | 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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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| Pre-1990 | Added | Code added. |
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