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2025 CPT code 64718

Neuroplasty and/or transposition of the ulnar nerve at the elbow.

Adhere to current CPT guidelines for surgical procedures on the nervous system.Accurate documentation is crucial for proper coding.

Modifiers may be applicable depending on the circumstances of the procedure.For instance, modifier 51 (multiple procedures) may be used if other procedures were performed during the same surgical session.Consult the CPT manual and NCCI guidelines for appropriate modifier usage.

Medical necessity for this procedure is established by documentation of symptoms consistent with ulnar nerve compression at the elbow (e.g., paresthesia, weakness, muscle atrophy) that are unresponsive to conservative management. Imaging findings may further support the diagnosis.The procedure is medically necessary to alleviate symptoms and restore function.

The clinical responsibility rests with a surgeon specializing in peripheral nerve surgery.The surgeon will perform the surgical procedure, including making incisions, identifying the compressed nerve, performing external neurolysis and/or transposition, and closing the incision. Pre-operative and post-operative care may involve other medical professionals such as anesthesiologists and nurses.

IMPORTANT:For percutaneous neurolysis, see codes 62263, 62264, 62280-62282. For internal neurolysis requiring use of an operating microscope, use code 64727. For facial nerve decompression, use code 69720. For neuroplasty with nerve wrapping, see codes 64702-64727, 64999. For intracranial surgery on cranial nerves, see codes 61450, 61460, 61790.

In simple words: This code describes surgery to fix a pinched ulnar nerve at the elbow. The surgeon will cut away scar tissue or bone to release pressure on the nerve and may move the nerve to a less-irritated position. This nerve controls feeling and movement in parts of the arm and hand.

This CPT code 64718 represents the surgical procedure involving neuroplasty and/or transposition of the ulnar nerve at the elbow.The procedure includes surgical decompression or freeing of the ulnar nerve from any entrapping scar tissue or other compressive structures. This may involve external neurolysis (releasing the nerve from surrounding tissue without entering the nerve itself), and/or transposition (repositioning the nerve to alleviate compression).Bone spurs or damaged muscle tissue may also be removed if contributing to the compression.

Example 1: A 45-year-old male presents with chronic ulnar nerve entrapment at the elbow due to cubital tunnel syndrome.The patient reports persistent paresthesia and weakness in the hand.The surgeon performs an open ulnar nerve decompression with external neurolysis and transposition., A 60-year-old female sustains a laceration to the ulnar nerve at the elbow during a fall.The surgeon performs a neuroplasty with repair of the nerve and transposition to prevent future compression., A 28-year-old male presents with symptoms consistent with ulnar nerve compression at the elbow. Imaging reveals a bone spur impinging on the nerve. The surgeon performs an open ulnar nerve decompression with removal of the bone spur and external neurolysis.

* Thorough history and physical examination documenting symptoms of ulnar nerve compression.* Detailed operative report describing the surgical procedure and findings (e.g., presence of scar tissue, bone spurs).* Imaging studies (e.g., ultrasound, MRI) to confirm diagnosis and guide surgical approach.* Post-operative notes documenting the patient’s recovery and any complications.*Any relevant pre-operative or post-operative consultations

** Always consult the most up-to-date CPT and NCCI guidelines and payer-specific policies for accurate coding and billing.This information is for educational purposes and does not constitute medical advice. The information provided is current as of December 3rd, 2024.

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