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The procedure described by CPT® Code 64786 involves the excision of a neuroma located on the sciatic nerve. A neuroma is a benign growth that can develop on a nerve, often resulting in pain and discomfort. In this procedure, a surgical incision is made directly over the site of the neuroma to allow access to the affected area. The surrounding soft tissues are carefully dissected to expose the neuroma, which is then meticulously separated from the surrounding tissue before being excised. After the neuroma is removed, the incision is closed. This procedure is specifically designated for neuromas of the sciatic nerve, distinguishing it from similar procedures that may involve other major peripheral nerves, which are coded differently, such as CPT® Code 64784 for neuromas of nerves other than the sciatic nerve.
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The excision of a neuroma of the sciatic nerve, as described by CPT® Code 64786, is indicated for patients experiencing significant pain or discomfort due to the presence of a neuroma. This condition may arise from various factors, including trauma, repetitive stress, or nerve injury, leading to the formation of a painful lesion on the sciatic nerve. The procedure is typically considered when conservative treatments have failed to alleviate symptoms, and the neuroma is causing functional impairment or persistent pain that affects the patient's quality of life.
The excision of a neuroma of the sciatic nerve involves several key procedural steps that ensure the effective removal of the lesion while minimizing damage to surrounding tissues.
Following the excision of a neuroma of the sciatic nerve, patients can expect a recovery period that may involve pain management and rehabilitation. Post-operative care typically includes monitoring for any signs of infection, managing pain with prescribed medications, and following up with the healthcare provider to assess healing. Physical therapy may be recommended to restore function and strength in the affected area. Patients are advised to avoid strenuous activities during the initial recovery phase to ensure proper healing of the surgical site.
| Short Descr | REMOVE SCIATIC NERVE LESION | Medium Descr | EXCISION NEUROMA SCIATIC NERVE | Long Descr | Excision of neuroma; sciatic 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 |
This is a primary code that can be used with these additional add-on codes.
| 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) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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.) | 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). | 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 | CR | Catastrophe/disaster related | 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) | 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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