2025 CPT code 64858
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Suture of the sciatic nerve.
Modifiers may be applicable based on circumstances. Consult the CPT manual and payer guidelines.
Surgical repair of the sciatic nerve is medically necessary when there is significant neurological deficit (e.g., loss of motor or sensory function) resulting from a traumatic injury, compression, or other pathology that cannot be managed conservatively.
The surgeon is responsible for all aspects of the procedure, including pre-operative preparation, nerve location and repair, and post-operative care.Anesthesia is typically provided by an anesthesiologist, but the surgeon may administer anesthesia in certain settings (modifier 47).
In simple words: The doctor repairs a damaged sciatic nerve in the leg.This is done by making a cut, finding the damaged part of the nerve, and carefully sewing it back together. Sometimes other repairs are needed as well.
This CPT code describes the surgical repair of a damaged sciatic nerve.The procedure involves locating the damaged nerve, preparing the nerve ends for repair (cleaning), aligning the nerve endings, and suturing the nerve ends together using sutures placed through the epineurium.Additional sutures may be required depending on the size of the nerve.Nerve reconstruction may also be performed as part of the procedure, followed by closure of the surgical site.This code does not include separate reporting of reconstruction or closure, which should be reported separately.
Example 1: A patient presents after a motorcycle accident with a complete transection of the sciatic nerve in the thigh.The surgeon performs an open repair using end-to-end anastomosis., A patient with a history of diabetes mellitus presents with a significant crush injury to the sciatic nerve at the buttock.The surgeon performs a nerve graft to repair the extensive damage., A patient presents with progressive foot drop secondary to a gunshot wound to the sciatic nerve several months prior.The surgeon performs exploration, neurolysis and repair.
* Thorough history and physical exam documenting the mechanism of injury and neurological deficits.* Pre-operative imaging (e.g., MRI, CT) demonstrating the extent of nerve injury.* Operative report detailing the surgical technique, type of repair (anastomosis, graft), and any complications encountered.* Post-operative neurological exam documenting recovery of function.* Physical therapy notes showing progress toward functional recovery.
** This code encompasses a range of complexities in sciatic nerve repair.The level of repair (thigh vs. buttock), the extent of injury, and the need for nerve grafts all influence the surgical approach and overall time involved.Proper documentation is crucial to ensure accurate coding.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: The RVUs for this code vary depending on the payer and location.Consult a fee schedule for the specific RVU values.
- Global Days : The global period for this code is not explicitly defined but likely follows general surgical guidelines. Consult specific payer policies for details.
- Payment Status: Active
- Modifier TC rule: TC modifiers are not typically used with this code, but they might apply in specific circumstances, consult current guidelines.
- Fee Schedule : Fee schedules vary by payer and geographic location. The provided fee data reflects past rates and should not be used for current reimbursement estimations.Consult the appropriate fee schedule.
- Specialties:Neurosurgery, Orthopedic Surgery, Plastic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center