2025 CPT code 64901
Effective Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure)
This code is an add-on code and generally does not require modifiers. However, the primary procedure code with which it is used may require modifiers depending upon the circumstances.
Medical necessity for 64901 must be supported by documentation of the specific nerve injury and the need for an additional single-strand nerve graft repair in conjunction with the primary nerve repair.This may involve electrodiagnostic studies, physical exam findings, and imaging studies.
The physician is responsible for harvesting the nerve graft, preparing the recipient nerve site, performing the graft, ensuring proper placement and protection of the graft, and closing the surgical site(s).They also must document the entire procedure meticulously.
In simple words: This procedure involves grafting an additional single strand of nerve tissue to repair a second damaged nerve during the same surgery session as the repair of the first nerve. The surgeon takes a small piece of healthy nerve from elsewhere in the body and uses it to bridge the gap in the damaged nerve, helping to restore its function.
This add-on code describes each additional single strand nerve graft repair, using a portion of unrelated nerve, to bridge or repair the injured portion of a subsequent nerve at the same session as an initial bridge or repair of an initial nerve. The provider harvests a single strand nerve graft, either from the previously harvested nerve or a new donor site. An incision is made, the nerve is located, and the desired length is cut. The donor site is then closed. The damaged portion of the subsequent nerve is accessed, either through the initial incision or a new one, and resected. The donor nerve graft is sutured to the transected nerve, ensuring protection with soft tissue and no obstruction or compression. Finally, the wound is closed.
Example 1: A patient sustains injuries to two nerves in their hand during a laceration. The surgeon performs a primary nerve repair on the first nerve and uses 64901 to report the additional single-strand nerve graft performed on the second nerve during the same session., During facial surgery, two branches of the facial nerve are found to be severed. The surgeon repairs the first nerve and then performs an additional single strand nerve graft on the second branch, using 64901., A patient undergoes leg surgery where two nerves are damaged. The surgeon performs a nerve repair using a conduit on one nerve and performs a single strand nerve graft on a second nerve in the same surgical session. They would report the primary repair and bill 64901 for the additional graft.
Documentation should include the diagnosis, the location and type of nerve injury, the source of the nerve graft, the technique used for the graft repair, and any complications encountered. Operative reports must be detailed and support the medical necessity of the procedures.
** Code 64902 is used for each additional nerve graft involving multiple strands.Ensure proper coding based on the type of graft performed.
- Revenue Code: P5E - AMBULATORY PROCEDURES - OTHER
- Modifier TC rule: Modifier TC is not applicable to this code as it is a surgical service.
- Specialties:Plastic Surgery, Neurosurgery, Orthopedic Surgery, Hand Surgery, ENT
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient