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The vagus nerve, known as the tenth cranial nerve, plays a crucial role in the autonomic nervous system, influencing various bodily functions. It originates from the brainstem and extends through the neck, thorax, and abdomen, branching out to innervate multiple organs, including the stomach and upper digestive tract. In the context of CPT® Code 64755, the procedure involves the transection or avulsion of the vagus nerves that are proximal to the stomach. This surgical intervention is primarily aimed at reducing excessive acid production in the stomach, which can help prevent the formation of peptic ulcers. The procedure may be referred to by several names, including selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, and supra or highly selective vagotomy. During the operation, a midline upper abdominal incision is made to provide access to the stomach and the vagus nerve. The surgeon identifies the main vagal trunks and dissects them up to the branch that leads to the biliary tree, ensuring precise transection to minimize impact on surrounding structures. This targeted approach is essential for achieving the desired therapeutic outcomes while preserving as much function as possible in the digestive system.
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The procedure described by CPT® Code 64755 is indicated for specific conditions related to excessive gastric acid production. The following are the primary indications for performing this surgical intervention:
The surgical steps involved in CPT® Code 64755 are as follows:
Following the procedure, patients are typically monitored for any immediate complications related to the surgery. Post-operative care may include pain management, monitoring for signs of infection, and ensuring proper recovery of gastrointestinal function. Patients may be advised on dietary modifications to accommodate changes in gastric function due to the vagotomy. The expected recovery period can vary, but patients are generally encouraged to follow up with their healthcare provider to assess healing and address any concerns that may arise during the recovery process.
| Short Descr | INCISION OF STOMACH NERVES | Medium Descr | TRANSECTION/AVULSION VAGUS NERVES | Long Descr | Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy) | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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