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The CPT® Code 64874 refers to the surgical procedure involving the suture of a nerve that necessitates extensive mobilization or transposition of the nerve. This procedure is typically required when a standard nerve suture cannot be performed due to tension on the nerve, which can occur when the nerve ends are not in close proximity to each other after an injury. In such cases, additional surgical techniques are employed to ensure that the nerve can be sutured without tension, which is critical for optimal healing and function. The mobilization process involves carefully freeing the nerve from surrounding tissues both distally and proximally, allowing for greater flexibility and movement of the nerve. If this mobilization alone does not suffice to achieve a tension-free repair, the nerve may be transposed, meaning it is rerouted through a different pathway, which may include creating a soft tissue tunnel. This procedure is often performed under microscopic visualization to enhance precision and minimize damage to surrounding structures. The complexity of this procedure underscores the need for careful planning and execution to ensure successful nerve repair and recovery.
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The procedure associated with CPT® Code 64874 is indicated in specific scenarios where nerve repair is necessary but complicated by tension on the nerve ends. The following conditions may warrant the use of this code:
The procedure for CPT® Code 64874 involves several critical steps to ensure successful nerve repair. Each step is designed to address the complexities associated with nerve injuries that require extensive mobilization or transposition.
Post-procedure care following the suture of a nerve with extensive mobilization or transposition is critical for recovery. Patients may require monitoring for signs of nerve function restoration and potential complications. Rehabilitation may include physical therapy to regain strength and mobility in the affected area. The surgical site should be kept clean and dry, and any signs of infection or unusual pain should be reported to the healthcare provider promptly. Follow-up appointments are essential to assess the healing process and the effectiveness of the nerve repair.
| Short Descr | REPAIR & REVISE NERVE ADD-ON | Medium Descr | SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE | Long Descr | Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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) | 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | 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 an add-on code that must be used in conjunction with one of these primary codes.
| 64831 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Suture of digital nerve, hand or foot; 1 nerve | 64832 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure) | 64834 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Suture of 1 nerve; hand or foot, common sensory nerve | 64835 | MPFS Status: Active Code APC J1 ASC A2 Suture of 1 nerve; median motor thenar | 64836 | MPFS Status: Active Code APC J1 ASC A2 Suture of 1 nerve; ulnar motor | 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) | 64840 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Suture of posterior tibial nerve | 64856 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Suture of major peripheral nerve, arm or leg, except sciatic; including transposition | 64857 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Suture of major peripheral nerve, arm or leg, except sciatic; without transposition | 64858 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Suture of sciatic nerve | 64859 | Addon Code MPFS Status: Active Code APC N ASC N1 Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure) | 64861 | MPFS Status: Active Code APC J1 ASC A2 Suture of; brachial plexus | 64862 | MPFS Status: Active Code APC J1 ASC A2 Suture of; lumbar plexus | 64864 | MPFS Status: Active Code APC J1 ASC A2 Suture of facial nerve; extracranial | 64865 | MPFS Status: Active Code APC J1 ASC J8 Suture of facial nerve; infratemporal, with or without grafting |
| 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.) | 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. |