2025 CPT code 64727
Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Internal neurolysis using an operating microscope. This is reported separately, in addition to the primary neuroplasty code.
Modifiers may be applicable. Refer to NCCI guidelines.
Medical necessity must be established by demonstrating the functional impairment caused by the nerve compression and scar tissue, and how the internal neurolysis is expected to improve nerve function and alleviate the patient's symptoms.
The physician preps and anesthetizes the patient, makes an incision, locates the affected nerve, uses a microscope and microsurgical techniques to open the nerve sheath, excises scar tissue, and closes the incision.
In simple words: The surgeon uses a microscope and tiny instruments to remove scar tissue from inside and around the nerve fibers. This helps to free up the nerve and improve its function, especially after an injury where it was compressed.
Internal neurolysis involves the surgical decompression of an intact nerve from scar tissue using an operating microscope and microsurgical techniques. The procedure requires meticulous dissection of the scar tissue from within and between the nerve fibers to free the nerve and restore its function.It is often performed as part of a more extensive neuroplasty procedure to optimize nerve regeneration, particularly in cases of nerve compression injuries.
Example 1: A patient with carpal tunnel syndrome undergoes a carpal tunnel release (64722) and the surgeon performs internal neurolysis (64727) to address scar tissue around the median nerve., A patient with cubital tunnel syndrome has ulnar nerve transposition (64742) and the surgeon also performs internal neurolysis (64727) to remove scar tissue impinging on the nerve., Following a traumatic nerve injury in the arm, a patient undergoes neuroplasty (64702) and the surgeon performs internal neurolysis (64727) to address scar tissue at the injury site, promoting better nerve regeneration.
Documentation should include the diagnosis, the operative report detailing the internal neurolysis procedure, including the use of the operating microscope and the extent of scar tissue removal, and any associated neuroplasty procedures performed.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- Specialties:Neurosurgery, Plastic Surgery, Orthopedic Surgery, Hand Surgery
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital