© Copyright 2025 American Medical Association. All rights reserved.
A nerve pedicle transfer is a surgical procedure that involves the transfer of a nerve along with a muscle pedicle, which includes the motor endplate of the nerve. This procedure is typically performed in two stages. In the first stage, represented by CPT® Code 64905, the surgeon develops and transfers the nerve pedicle to a designated donor site. The process begins with making an incision over the injured nerve, followed by the elevation of skin, fascial, or muscle flaps as necessary to expose the injured nerve and its branches. The incision may be extended, or a second incision may be created at the site where the nerve pedicle will be harvested. Utilizing microscopic visualization, the surgeon carefully dissects the donor nerve and its motor endplate from the surrounding tissues, along with the associated muscle tissue. A tunnel is then created from the donor site to the injured nerve, allowing the nerve pedicle to be pulled through this tunnel to the injury site. Once in position, the nerve pedicle is secured to the injury site with sutures. In the second stage, denoted by CPT® Code 64907, after the nerve axons have regenerated and normal nerve function has been restored, the nerve pedicle is severed at its original site. This staged approach allows for the restoration of nerve function while ensuring that the nerve pedicle is properly integrated into the surrounding tissues before final severance.
© Copyright 2025 Coding Ahead. All rights reserved.
The nerve pedicle transfer procedure is indicated for patients who have sustained nerve injuries that require surgical intervention to restore function. The following conditions may warrant this procedure:
The nerve pedicle transfer procedure consists of several critical steps that ensure the successful transfer and integration of the nerve pedicle. The following outlines the procedural steps involved:
After the nerve pedicle transfer procedure, patients can expect a recovery period during which nerve axons will regenerate and nerve function will gradually return. Post-procedure care may include monitoring for signs of infection, managing pain, and following rehabilitation protocols to promote recovery. The surgeon will provide specific instructions regarding activity restrictions and follow-up appointments to assess the healing process. Once nerve function has been restored, the final step involves severing the nerve pedicle at its site of origin, which is performed in the second stage of the procedure.
| Short Descr | NERVE PEDICLE TRANSFER | Medium Descr | NERVE PEDICAL TRANSFER SECOND STAGE | Long Descr | Nerve pedicle transfer; second stage | 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 | 1 | 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.
| 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). | 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |