CPT® Code 64901

Add-On Code

1. Indications

The procedure associated with CPT® Code 64901 is indicated for the repair of additional nerves following the initial repair of a primary nerve. The specific indications for this procedure include:

• Injury to Peripheral Nerves - This procedure is performed when there is damage to peripheral nerves that necessitates surgical intervention for repair.
• Need for Nerve Grafting - When the nerve ends cannot be directly sutured together due to the extent of the injury, nerve grafting becomes necessary to restore function.
• Evaluation of Nerve Function - Prior to the procedure, nerve testing and monitoring may indicate the need for additional repairs based on the assessment of nerve function.

2. Procedure

The procedure for CPT® Code 64901 involves several detailed steps, which are as follows:

• Step 1: Exposure of the Injured Nerve - The surgical team begins by exposing the injured nerve to assess the extent of the damage. This step is crucial for determining the appropriate course of action for repair.
• Step 2: Debridement of Damaged Tissue - Any damaged or necrotic tissue surrounding the nerve is carefully debrided to create a clean area for the grafting procedure. This ensures that only healthy tissue is involved in the repair.
• Step 3: Nerve Function Evaluation - Separately reportable nerve testing and monitoring may be performed to evaluate the function of the nerve, providing critical information for the surgical approach.
• Step 4: Microscopic Visualization - Using microscopic techniques, the healthy proximal and distal segments of the nerve are meticulously dissected free from surrounding tissue. This step is essential for ensuring that the graft can be properly aligned with the nerve ends.
• Step 5: Harvesting the Nerve Graft - The length of the nerve graft is determined, and the donor nerve is exposed. The desired length of the graft is dissected free from surrounding tissue, and the graft is divided proximally and distally for harvesting.
• Step 6: Suturing the Graft - Single or multiple strands of the harvested donor nerve are then sutured end-to-end to the severed ends of the injured nerve, facilitating the reconnection of nerve pathways.
• Step 7: Repair of Overlying Tissues - Finally, the overlying soft tissues and skin are repaired in layers to ensure proper healing and restoration of the surgical site.

3. Post-Procedure

After the completion of the nerve grafting procedure, patients may require specific post-operative care to ensure optimal recovery. This includes monitoring for any signs of infection at the surgical site, managing pain, and following up with physical therapy to promote nerve function and mobility. The expected recovery period may vary depending on the extent of the nerve injury and the individual patient's healing process. Regular follow-up appointments are essential to assess the success of the graft and the restoration of nerve function.