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The procedure described by CPT® Code 64836 involves the surgical suture of a single ulnar motor nerve. This nerve is a critical component of the peripheral nervous system, primarily responsible for motor function in the hand. The suture repair of the nerve, often referred to as end-to-end closure, is a technique employed to restore continuity and function following nerve injury. The procedure can be performed using various techniques depending on the location and extent of the nerve damage. For injuries that are more distal, an epineural closure technique is typically utilized, where the outer layer of the nerve, known as the epineurium, is sutured to bring the two ends of the transected nerve together without applying tension. In contrast, for more proximal injuries, a perineural closure technique may be employed, which involves suturing the individual fascicles of axons within the nerve. This method allows for a more precise alignment of the nerve fibers that are responsible for specific functions, ensuring optimal recovery and restoration of motor capabilities. The procedure is critical for patients who have sustained nerve injuries, as it aims to restore normal function and alleviate symptoms associated with nerve damage.
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The suture of the ulnar motor nerve, as described by CPT® Code 64836, is indicated for specific conditions and symptoms associated with nerve injuries. These include:
The procedure for suturing the ulnar motor nerve involves several critical steps to ensure proper repair and restoration of nerve function. The following procedural steps are typically followed:
After the suture of the ulnar motor nerve is completed, post-procedure care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Rehabilitation may be necessary to restore function, which can include physical therapy focused on regaining strength and mobility in the affected hand. The expected recovery time can vary based on the extent of the injury and the success of the repair, but patients are generally advised to follow up with their healthcare provider to assess nerve function and progress in recovery. Proper wound care and adherence to rehabilitation protocols are crucial for achieving the best possible outcomes following this surgical procedure.
| Short Descr | REPAIR OF HAND OR FOOT NERVE | Medium Descr | SUTURE 1 NERVE ULNAR MOTOR | Long Descr | Suture of 1 nerve; ulnar motor | 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.
| 0882T | New Code for 2024 Add on code MPFS Status: Carrier Priced APC N ASC N1 Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (List separately in addition to code for primary procedure) | 64837 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Suture of each additional nerve, hand or foot (List separately in addition to code for primary procedure) | 64872 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy) | 64874 | Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) | 64876 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Suture of nerve; requiring shortening of bone of extremity (List separately in addition to code for nerve suture) | 69990 | Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) |
| 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F8 | Right hand, fourth digit | FA | Left hand, thumb | 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 |
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| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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