CPT® Code 64896

1. Indications

The procedure associated with CPT® Code 64896 is indicated for the repair of a nerve in the hand or foot that has sustained injury. The following conditions may warrant the use of this procedure:

• Nerve Injury The procedure is performed when there is a significant injury to the nerve that necessitates reconstruction to restore function.
• Severed Nerve This procedure is indicated when the nerve has been completely severed, requiring a graft to reconnect the nerve ends.
• Inadequate Healing If previous attempts at nerve repair have failed or if the nerve has not healed adequately, a multiple strand nerve graft may be required.

2. Procedure

The procedure for CPT® Code 64896 involves several critical steps to ensure a successful nerve grafting. The following outlines the procedural steps:

• Step 1: Exposure of the Injured Nerve The surgeon begins by making an incision to expose the injured nerve in the hand or foot. This allows for a thorough evaluation of the extent of the nerve damage.
• Step 2: Evaluation and Debridement Once the nerve is exposed, the surgeon assesses the injury. Any damaged or necrotic tissue is debrided to prepare the site for grafting, ensuring that only healthy tissue remains.
• Step 3: Nerve Testing and Monitoring If necessary, nerve testing and monitoring may be performed to evaluate the function of the nerve. This step is crucial for determining the appropriate course of action for repair.
• Step 4: Dissection of Healthy Nerve Segments The healthy proximal and distal segments of the nerve are carefully dissected free from surrounding tissue. This dissection is performed under microscopic visualization to enhance precision.
• Step 5: Harvesting the Nerve Graft The surgeon then harvests the nerve graft from a donor site. The donor nerve is exposed, and the desired length is dissected free from surrounding tissue. The graft is divided proximally and distally for use in the repair.
• Step 6: Suturing the Graft Multiple strands of the harvested donor nerve are sutured end-to-end to the severed ends of the injured nerve. This technique allows for a tension-free repair, which is essential for optimal healing.
• Step 7: Closure of Soft Tissues After the nerve graft has been successfully placed, the overlying soft tissues and skin are repaired in layers to complete the procedure, ensuring proper healing and minimizing scarring.

3. Post-Procedure

Following the procedure coded as CPT® 64896, patients may require specific post-operative care to promote healing and recovery. This may include monitoring for signs of infection at the surgical site, managing pain with prescribed medications, and following up with physical therapy to regain function in the affected area. Patients are typically advised to avoid strenuous activities that could stress the repaired nerve during the initial healing phase. Regular follow-up appointments may be necessary to assess the success of the nerve repair and to monitor the recovery process.