CPT® Code 64876

Add-On Code

1. Indications

The procedure associated with CPT® Code 64876 is indicated in cases where a nerve injury requires surgical intervention that cannot be adequately addressed without modifying the surrounding bony structures. The following conditions may warrant this procedure:

• Severe Nerve Injury: When a nerve has sustained significant damage that necessitates surgical repair, and the surrounding bone structure impedes the repair process.
• Adhesions or Scar Tissue: Presence of scar tissue or adhesions that restrict the movement of the nerve, requiring additional surgical steps to free the nerve for effective repair.
• Tension-Free Repair Requirement: Situations where the nerve cannot be sutured without shortening the bone to achieve a tension-free repair, ensuring optimal healing and function.

2. Procedure

The procedure for CPT® Code 64876 involves several critical steps to ensure the successful repair of the nerve while addressing the bony structure. The following procedural steps are performed:

• Step 1: Exposure of the Nerve The surgical team begins by carefully exposing the injured nerve. This may involve incisions and dissection to access the nerve while minimizing damage to surrounding tissues.
• Step 2: Identification of Bone Cuts Once the nerve is exposed, the surgeon identifies the specific sites on the bone that require cutting. This step is crucial for determining how much bone needs to be excised to facilitate the nerve repair.
• Step 3: Osteoplasty The surgeon performs an osteoplasty, which involves cutting the bone and excising a segment. This action shortens the bone of the extremity, allowing for the necessary adjustments to be made for the nerve repair.
• Step 4: Reconfiguration of Bone After the bone segment is excised, the remaining distal and proximal portions of the bone are brought into contact with each other. This step is essential for restoring the structural integrity of the bone.
• Step 5: Stabilization The final step involves applying internal fixation to stabilize the reconfigured bone. Alternatively, an external fixation device may be utilized to ensure that the bone remains properly aligned during the healing process.

3. Post-Procedure

Post-procedure care for CPT® Code 64876 includes monitoring the surgical site for signs of infection and ensuring proper healing of both the nerve and the bone. Patients may require pain management and physical therapy to regain function in the affected extremity. Follow-up appointments are essential to assess the healing process and the success of the nerve repair. The healthcare team will provide specific instructions regarding activity restrictions and rehabilitation to optimize recovery.