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The procedure described by CPT® Code 64763 involves the transection or avulsion of the obturator nerve, which is located outside the pelvis (extrapelvic). The obturator nerve is a critical nerve that originates from the lumbar plexus, travels through the pelvis, and enters the thigh via the obturator canal. This nerve is responsible for innervating the adductor muscles of the thigh, which are essential for movements such as bringing the legs together. In this procedure, a surgical incision is made over the lateral aspect of the hip, allowing access to the underlying tissues. The surgeon dissects through the subcutaneous layers to expose the adductor tendon, which may be incised if necessary to facilitate access to the nerve. The anterior branch of the obturator nerve is then identified and either transected, meaning it is cut, or avulsed, which involves forcibly separating it from its connection to the main obturator nerve. This procedure may be indicated for various conditions affecting the obturator nerve or its function, and it is important to note that it is distinct from CPT® Code 64766, which pertains to an intrapelvic approach to the same nerve.
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The procedure described by CPT® Code 64763 is indicated for specific conditions affecting the obturator nerve. These may include:
The procedure involves several key steps to effectively transect or avulse the obturator nerve:
After the procedure, patients may require specific post-operative care to ensure proper healing and recovery. This may include monitoring for any signs of complications, managing pain, and following up with physical therapy to restore function. The expected recovery time can vary based on individual circumstances and the extent of the procedure performed. Patients should be advised on activity restrictions and signs of potential complications that may require further medical attention.
| Short Descr | INCISE HIP/THIGH NERVE | Medium Descr | TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY | Long Descr | Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy | 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) | P1G - Major procedure - 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). | 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. | 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.) | 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). | 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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