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The procedure described by CPT® Code 64897 involves the surgical repair of a nerve in the arm or leg using a multiple strand nerve graft. This technique is employed to facilitate a tension-free repair of an 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 utilizes microscopic visualization to enhance the precision of the surgery. The healthy segments of the nerve, both proximal and distal to the injury, are meticulously dissected from the surrounding tissue to prepare for grafting. The length of the required nerve graft is then determined, and the graft is harvested from a donor site, which involves exposing the donor nerve and dissecting it free from surrounding tissue to obtain the desired length. The graft is subsequently divided at both ends and sutured end-to-end to the severed ends of the injured nerve. Finally, the overlying soft tissues and skin are repaired in layers to complete the procedure. This code is specifically applicable when the length of the multiple strand nerve graft is 4 cm or less, while a different code, CPT® 64898, is used for grafts exceeding this length.
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The procedure associated with CPT® Code 64897 is indicated for the repair of nerve injuries in the arm or leg. The following conditions may warrant the use of this nerve grafting technique:
The procedure for CPT® Code 64897 involves several critical steps to ensure a successful nerve grafting. The following outlines the procedural steps:
After the completion of the nerve grafting procedure, patients may require specific post-operative care to ensure optimal 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 limb. The recovery process can vary depending on the extent of the nerve injury and the individual patient's healing response. Regular follow-up appointments are essential to assess the success of the graft and the restoration of nerve function.
| Short Descr | NRV GRF MLTST ARM/LEG <4 CM | Medium Descr | NERVE GRAFT MLT STRANDS ARM/LEG <4 CM | Long Descr | Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 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) | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | 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.
| 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) | 64902 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Nerve graft, each additional nerve; multiple strands (cable) (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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, 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 | 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 | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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