2025 CPT code 64886
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Neurorrhaphy With Nerve Graft, Vein Graft or Conduit Procedures Surgical Procedures on the Nervous System Feed
Nerve graft (includes obtaining graft), head or neck; more than 4 cm length.
Modifiers may be applicable depending on the specific circumstances of the procedure.Consult the official CPT coding guidelines and the NCCI edits for appropriate modifiers.
Medical necessity for nerve grafting is established when significant functional deficits (sensory or motor) result from nerve damage or transection that cannot be adequately addressed by other less invasive means. Documentation must clearly demonstrate the extent of nerve damage and how the graft procedure addresses it.
The surgeon's responsibilities include patient preparation, anesthesia administration (or coordination with the anesthesiologist), harvesting the nerve graft (incision, identification, resection, and repair of the donor site), preparation of the recipient nerve site (excision of damaged tissue), meticulous placement and suturing of the graft, wound closure, and postoperative care.The surgeon must ensure the graft is not obstructed or compressed to ensure proper nerve regeneration.
- Surgical Procedures on the Nervous System
- Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System
In simple words: The doctor repairs a damaged nerve in the head or neck using a healthy nerve segment from another part of the body (usually the leg). This longer-than-4cm nerve piece bridges the damaged area, helping restore feeling and movement.
This CPT code encompasses the surgical procedure of neurorrhaphy with a nerve graft, specifically in the head or neck region, where the graft utilized is longer than 4 centimeters.The procedure involves harvesting a suitable nerve segment (often from the sural nerve in the leg), preparing the recipient nerve site by removing the damaged portion, and meticulously suturing the graft to bridge the gap, ensuring proper alignment and minimal tension.The goal is to restore sensory and/or motor function compromised by nerve damage or transection. The code includes obtaining the graft.
Example 1: A patient sustains a severe laceration to the neck, resulting in complete transection of the brachial plexus. A nerve graft of greater than 4cm is required to restore motor function to the arm., A patient presents with chronic nerve compression in the face, resulting in significant sensory deficits. A nerve graft is used to address the damage and restore sensation., A patient undergoes surgical removal of a tumor in the head and neck, resulting in damage to nearby nerves.A nerve graft exceeding 4cm is needed to repair the resulting functional deficits.
Detailed operative notes including the type and length of the nerve graft used, the location of both donor and recipient sites, meticulous description of surgical technique, confirmation of graft patency, intraoperative findings (e.g., evidence of nerve continuity), and postoperative assessments of neurological function.Preoperative imaging (e.g., MRI, CT) may also be needed to show the extent of the nerve damage.Appropriate documentation regarding medical necessity should also be present.
** The length of the nerve graft is a critical element in determining the appropriate code and the reimbursement.Always ensure that the documentation accurately reflects the length of the graft used and that all associated services are correctly reported.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: This information is not available in the provided source.Consult the current year's CPT manual or a relevant billing database for RVU values.The value will vary based on geographic location and other factors.
- Global Days: This information is not provided in the source.The global period will depend on the specific payer and may vary based on the complexity of the procedure and any associated services.
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier depends on the specific arrangement and billing practices between the surgeon and the facility (hospital, ambulatory surgery center, etc.).
- Fee Schedule: Historical fee schedule data is not provided here.For historical fee schedules, consult resources specific to the payer or jurisdiction in question.
- Specialties:Neurosurgery, Plastic Surgery, Orthopedic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital (Inpatient or Outpatient), Office