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The procedure described by CPT® Code 64782 involves the excision of a neuroma located in the hand or foot, specifically excluding the digital nerves. A neuroma is a benign growth that can develop on a nerve, often resulting in pain or discomfort. During this surgical procedure, a skin incision is made directly over the neuroma to allow access to the affected nerve. The surgeon carefully exposes the neuroma, ensuring that it is adequately dissected from the surrounding tissue to prevent damage to adjacent structures. Once the neuroma is fully isolated, it is excised, meaning it is completely removed from the nerve. After the excision, the incision made in the skin is then closed, completing the procedure. It is important to note that this code is specifically used for the excision of a single neuroma affecting a nerve other than the digital nerve, while a different code, CPT® 64783, is designated for the excision of additional neuromas in the hand or foot that are not digital nerves.
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The excision of a neuroma in the hand or foot is indicated for patients experiencing significant pain or discomfort due to the presence of a neuroma. This procedure is typically considered when conservative treatments, such as medication or physical therapy, have failed to provide relief. The following conditions may warrant the excision of a neuroma:
The procedure for excising a neuroma in the hand or foot follows a series of well-defined steps to ensure effective removal and minimize complications. The steps are as follows:
After the excision of a neuroma, patients can expect a recovery period that may vary based on individual circumstances and the extent of the procedure. Post-procedure care typically includes managing pain with prescribed medications, keeping the surgical site clean and dry, and following any specific instructions provided by the healthcare provider. Patients are often advised to limit physical activity and avoid putting weight on the affected foot or hand for a specified period to promote healing. Follow-up appointments may be scheduled to monitor the healing process and address any concerns that may arise during recovery.
| Short Descr | REMOVE LIMB NERVE LESION | Medium Descr | EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE | Long Descr | Excision of neuroma; hand or foot, except digital 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies 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 | 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 | 2 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
This is a primary code that can be used with these additional add-on codes.
| 64783 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) | 64787 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision) |
| 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. | 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. | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | F3 | Left hand, fourth digit | F5 | Right hand, thumb | F7 | Right hand, third digit | F8 | Right hand, fourth digit | FA | Left hand, thumb | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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) | SG | Ambulatory surgical center (asc) facility service | T1 | Left foot, second digit | T2 | Left foot, third digit | T6 | Right foot, second digit | T7 | Right foot, third digit | T8 | Right foot, fourth digit | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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