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The procedure described by CPT® Code 64821 refers to a sympathectomy of the radial artery. A sympathectomy is a surgical intervention that involves the cutting or removal of sympathetic nerve fibers, which are part of the autonomic nervous system responsible for regulating blood flow and other involuntary functions. This specific procedure targets the radial artery, which is one of the major arteries in the forearm that supplies blood to the hand and fingers. The primary goal of performing a sympathectomy on the radial artery is to enhance blood circulation to the digits, particularly in patients suffering from severe ischemia—a condition characterized by insufficient blood flow. This procedure is often indicated for patients with conditions such as Raynaud's syndrome, which causes episodes of reduced blood flow to the fingers and toes, and scleroderma, a disease that can lead to vascular complications. By severing the sympathetic nerve connections to the radial artery, the procedure aims to alleviate symptoms associated with these conditions, thereby improving the overall blood supply to the affected areas. The surgical technique may involve the use of an operating microscope to ensure precision during the dissection and separation of the artery from adjacent structures.
© Copyright 2025 Coding Ahead. All rights reserved.
The sympathectomy of the radial artery, as described by CPT® Code 64821, is indicated for the following conditions:
The procedure for radial artery sympathectomy involves several key steps to ensure effective surgical intervention:
After the radial artery sympathectomy, patients may require monitoring for any complications related to the surgery. Expected recovery may include managing pain at the surgical site and monitoring for signs of improved blood flow to the digits. Patients are typically advised on post-operative care, which may include activity restrictions and follow-up appointments to assess healing and the effectiveness of the procedure. It is important for healthcare providers to provide clear instructions regarding wound care and signs of potential complications, such as infection or excessive swelling.
| Short Descr | SYMPATHECTOMY RADIAL ARTERY | Medium Descr | SYMPATHECTOMY RADIAL ARTERY | Long Descr | Sympathectomy; radial artery | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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) | 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). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F3 | Left hand, fourth digit | F5 | Right hand, thumb | 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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| 2025-01-01 | Changed | Short Description changed. |
| 2014-01-01 | Changed | Medium Descriptor Changed. Changed ULNAR to RADIAL per AMA 2014 corrections document posted 2014-03-24 |
| 2002-01-01 | Added | First appearance in code book in 2002. |