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The procedure described by CPT® Code 64913 involves the repair of an injured nerve using nerve allograft, specifically focusing on each additional strand utilized in the repair process. In this context, a nerve allograft refers to a graft taken from a donor (such as a cadaver) that is used to replace or repair a damaged nerve. The primary goal of this procedure is to achieve a tension-free repair of the nerve, which is crucial for facilitating the patient's own axonal regeneration following a nerve injury. During the procedure, the injured nerve is carefully exposed, and the extent of the injury is thoroughly evaluated. This evaluation is critical as it informs the surgeon about the necessary steps to restore nerve function effectively. Using microscopic visualization, the surgeon debrides and trims the proximal and distal ends of the injured nerve until healthy fascicular nerve structure is encountered, ensuring that the repair is made on viable tissue. The length of the nerve deficit and the diameter of the nerve are measured to select an appropriately sized and processed allograft. The allograft is then prepared and shaped to fit the specific requirements of the repair. The single-strand nerve graft is meticulously sutured to the epineurium of the damaged nerve, connecting the distal and proximal ends while preserving the anatomical structure of the nerve. In cases where large diameter nerves are involved, additional allograft strands may be necessary to adequately bridge the nerve deficit. The procedure concludes with the layered repair of the overlying soft tissues and skin, ensuring proper healing and restoration of function. It is important to note that if multiple nerve strand injuries are present, they can be repaired using allograft cables in a similar manner. This code, 64913, is used in conjunction with code 64912, which reports the first strand of nerve repair with allograft.
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The procedure associated with CPT® Code 64913 is indicated for patients who have sustained nerve injuries that require surgical intervention to restore nerve continuity and function. The following conditions may warrant the use of this procedure:
The procedure for nerve repair with nerve allograft, as described by CPT® Code 64913, involves several critical steps to ensure effective repair and restoration of nerve function. The following procedural steps are undertaken:
Post-procedure care following the nerve repair with nerve allograft is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies are implemented to ensure patient comfort during the recovery phase. Rehabilitation may be recommended to facilitate nerve regeneration and restore function, which may include physical therapy to improve strength and mobility in the affected area. Follow-up appointments are crucial to assess the healing process and the effectiveness of the nerve repair. The expected recovery time can vary based on the extent of the injury and the individual patient's healing response, but ongoing evaluation is necessary to ensure proper recovery and function restoration.
| Short Descr | NRV RPR W/NRV ALGRFT EA ADDL | Medium Descr | NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND | Long Descr | Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 3 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 64912 | MPFS Status: Active Code APC J1 ASC J8 Nerve repair; with nerve allograft, each nerve, first strand (cable) |
| 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F9 | Right hand, fifth digit | FA | Left hand, thumb | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2018-01-01 | Added | Code Added. |
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