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A nerve graft procedure involves the surgical repair of a damaged nerve in the hand or foot using a single strand of nerve tissue. This technique is employed to facilitate a tension-free repair of the injured nerve, which is crucial for restoring proper nerve function. During the procedure, the surgeon first exposes the injured nerve and assesses the extent of the damage. If necessary, any damaged tissue is carefully removed through a process known as debridement. To evaluate the function of the nerve, additional nerve testing and monitoring may be performed, which are reported separately. The procedure also involves the use of microscopic visualization to ensure precision. The healthy segments of the nerve, both proximal and distal to the injury, are meticulously dissected from the surrounding tissue. The length of the required nerve graft is then determined. A single strand nerve graft is harvested from a donor site, where the donor nerve is exposed, and the desired length is carefully dissected free. After the graft is obtained, it is divided at both ends and prepared for implantation. The graft is then sutured end-to-end to the severed ends of the injured nerve, allowing for reconnection. Finally, the overlying soft tissues and skin are repaired in layers to complete the procedure. It is important to note that this code, CPT® 64891, is specifically used when the length of the nerve graft exceeds 4 cm, while CPT® 64890 is applicable for grafts that are 4 cm or less.
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The nerve graft procedure is indicated for patients who have sustained nerve injuries in the hand or foot that require surgical intervention to restore function. The following conditions may warrant the use of this procedure:
The nerve graft procedure consists of several critical steps to ensure successful repair of the injured nerve. Each step is essential for achieving optimal outcomes.
After the nerve graft procedure, patients can expect a recovery period that may vary depending on the extent of the injury and the surgical intervention. Post-operative care typically includes monitoring for signs of infection, managing pain, and ensuring proper wound healing. Patients may also undergo physical therapy to regain strength and function in the affected area. Follow-up appointments are essential to assess the success of the graft and the recovery of nerve function. It is important for patients to adhere to their surgeon's post-operative instructions to optimize healing and functional recovery.
| Short Descr | NRV GRF 1STRND HND/FOOT >4CM | Medium Descr | NERVE GRAFT 1 STRAND HAND/FOOT >4 CM | Long Descr | Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length | 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) | 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) | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 2 | 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.
| 64901 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure) | 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). | 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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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Short Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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