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The CPT® Code 64911 refers to a specific surgical procedure known as nerve repair with the use of an autogenous vein graft, which includes the harvesting of the vein graft. This procedure is performed when nerve function is compromised due to injury, leading to the degeneration of the distal portion of the nerve. In such cases, the proximal nerve segment may still have the potential to regenerate; however, if the gap between the proximal and distal nerve stumps is too extensive, a graft is necessary to facilitate the reconnection and promote nerve regeneration. The procedure involves the insertion of a graft, which can either be a biological nerve tube allograft derived from human vein or a synthetic conduit designed to guide the regenerating axons. The use of an autogenous vein graft is particularly advantageous as it utilizes a vein harvested from the patient’s own body, ensuring biocompatibility and reducing the risk of rejection. During the procedure, the harvested vein is often turned inside out and sutured between the severed nerve ends, taking advantage of the collagen-rich inner layer of the vein wall, which is known to enhance nerve regeneration. As the nerve repair process progresses, new capillaries develop within the vein graft, allowing neurites from the proximal nerve stump to grow around them, thereby restoring the connection and function of the nerve. This code specifically captures the complexity and intricacies involved in repairing a single nerve using the patient’s own vein, highlighting the importance of both the harvesting and the surgical placement of the graft in the overall success of the nerve repair.
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The procedure associated with CPT® Code 64911 is indicated for patients who have experienced nerve injury resulting in the loss of nerve function. The following conditions may warrant the use of this nerve repair technique:
The procedure for nerve repair using CPT® Code 64911 involves several critical steps to ensure successful grafting and nerve regeneration:
Post-procedure care following the nerve repair using CPT® Code 64911 is essential for optimal recovery and includes monitoring for signs of infection, ensuring proper healing of the surgical site, and assessing the function of the repaired nerve. Patients may require physical therapy to facilitate rehabilitation and regain strength and function in the affected area. Follow-up appointments are crucial to evaluate the success of the nerve repair and to monitor the regeneration process, which can take several months. Additionally, patients should be educated on signs of complications, such as increased pain or loss of sensation, which should be reported to their healthcare provider promptly.
| Short Descr | NEURORRAPHY W/VEIN AUTOGRAFT | Medium Descr | NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE | Long Descr | Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve | 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 | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - 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) |
| 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). | 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. | 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. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F2 | Left hand, third digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met | 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) | SG | Ambulatory surgical center (asc) facility service | 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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| 2007-01-01 | Added | First appearance in code book in 2007. |
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