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Official Description

Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 64898 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 debrided to prepare the site for grafting. To evaluate nerve function, the surgeon may perform separately reportable nerve testing and monitoring. Utilizing microscopic visualization, the healthy segments of the nerve located both proximally and distally to the injury are carefully dissected from the surrounding tissue. The length of the required nerve graft is then determined, and the graft is harvested from a donor site. The donor nerve is exposed, and the surgeon dissects the desired length free from surrounding tissue, ensuring that the graft is suitable for use. The graft is then 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 meticulously repaired in layers to complete the procedure. It is important to note that CPT® Code 64898 is specifically used when the length of the multiple strand nerve graft exceeds 4 cm, while CPT® Code 64897 is applicable for grafts measuring 4 cm or less.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 64898 is indicated for the repair of nerve injuries in the arm or leg that require a grafting technique due to significant damage. The following conditions may warrant the use of this procedure:

  • Nerve Injury The procedure is performed when there is a severed or significantly damaged nerve that cannot heal on its own, necessitating surgical intervention.
  • Loss of Sensation or Function Patients experiencing loss of sensation or motor function in the arm or leg due to nerve damage may require this procedure to restore normal function.
  • Trauma Nerve grafting is often indicated following traumatic injuries, such as lacerations or crush injuries, that compromise nerve integrity.
  • Neuropathy In cases of neuropathy where nerve repair is necessary to alleviate symptoms and restore function, this procedure may be indicated.

2. Procedure

The procedure for CPT® Code 64898 involves several critical steps to ensure successful nerve repair:

  • Step 1: Exposure of the Injured Nerve The surgeon begins by making an incision to expose the injured nerve. This allows for a thorough evaluation of the extent of the nerve damage, which is essential for determining the appropriate course of action.
  • Step 2: Debridement of Damaged Tissue If there is any necrotic or damaged tissue surrounding the nerve, the surgeon performs debridement to remove this tissue. This step is crucial to prepare the nerve for grafting and to promote healing.
  • Step 3: Nerve Testing and Monitoring To assess the function of the nerve, the surgeon may conduct separately reportable nerve testing and monitoring. This helps in evaluating the viability of the nerve and the need for grafting.
  • Step 4: Dissection of Healthy Nerve Segments Using microscopic visualization, the surgeon carefully dissects the healthy proximal and distal segments of the nerve free from surrounding tissue. This dissection is performed with precision to preserve nerve function.
  • Step 5: Harvesting the Nerve Graft The surgeon then determines the required length of the nerve graft and proceeds to harvest it from a donor site. The donor nerve is exposed, and the desired length is dissected free from surrounding tissue.
  • Step 6: Suturing the Graft Once the graft is harvested, it is divided proximally and distally. The multiple strands of the donor nerve are then sutured end-to-end to the severed ends of the injured nerve, ensuring a secure connection for healing.
  • Step 7: Repair of Overlying Tissues After the nerve grafting is complete, the surgeon repairs the overlying soft tissues and skin in layers. This meticulous closure is important for proper healing and minimizing scarring.

3. Post-Procedure

Post-procedure care following the nerve grafting involves monitoring the surgical site for signs of infection and ensuring proper healing. Patients may be advised to limit movement in the affected area to promote recovery. Follow-up appointments are essential to assess nerve function and healing progress. Rehabilitation may be necessary to restore strength and function in the affected limb, and patients should be educated on the importance of adhering to post-operative instructions to optimize outcomes.

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; 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) 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 Surgical procedure on ASC list in CY 2007; 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)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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.)
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).
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)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
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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2024-01-01 Changed Short Description changed.
2013-01-01 Changed Short Descriptor changed.
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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