2025 CPT code 64823
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Sympathectomy of the superficial palmar arch.
Modifiers such as 50 (bilateral procedure), 51 (multiple procedures), and 22 (increased procedural services) may be appropriate depending on the circumstances of the surgical case.
Medical necessity for this procedure is established by the presence of significant pain or compromised blood flow in the hand unresponsive to conservative management.The severity of symptoms and the impact on the patient's daily activities should be documented.The procedure should be deemed medically necessary and the least invasive approach that would address the patient's condition.
The surgeon is responsible for pre-operative assessment,surgical technique,post-operative care, and ensuring the patient's safety throughout the procedure.Anesthesiologists may be involved in managing anesthesia during the procedure.
In simple words: This surgery removes or destroys tiny nerves in the hand to reduce pain or improve blood flow if the blood vessels are narrowed. The doctor makes a small cut, carefully removes the nerves, cleans the area, and stitches the cut closed.
Surgical removal or destruction of sympathetic nerves in the superficial palmar arch of the hand to alleviate pain or improve blood flow in patients with vascular compromise.The procedure involves meticulous dissection using loupe magnification to avoid injury to adjacent structures.The adventitial tissue surrounding the superficial palmar arch is carefully excised to remove the encircling sympathetic nerves. Following the procedure, the wound is irrigated and closed.
Example 1: A patient presents with severe pain and discoloration in the hand due to Raynaud's phenomenon.A sympathectomy of the superficial palmar arch is performed to improve blood flow and reduce pain., A patient with a history of vascular disease experiences persistent pain and cold sensitivity in the hand.Surgical sympathectomy is indicated to address the underlying vascular insufficiency., A patient post-trauma to the hand experiences chronic pain associated with nerve damage in the superficial palmar arch region.Surgical intervention, including sympathectomy, may be considered.
* Complete patient history and physical examination, including details about the onset, location, and character of pain, and relevant vascular assessment.* Pre-operative and post-operative imaging (e.g., angiography, ultrasound) to assess vascular status.* Operative report detailing the surgical technique, including the specific nerves addressed and any complications.* Post-operative clinical notes documenting pain management, recovery progress, and any complications.
** This procedure may be performed as an open surgical procedure or using minimally invasive techniques.The selection of the appropriate technique should be based on patient-specific factors and the surgeon's judgment. Always consult current coding guidelines and payer-specific policies for accurate billing and reimbursement.
- Revenue Code: P1G - MAJOR PROCEDURE - OTHER
- RVU: This information is not available in the provided source.To obtain RVU data, please consult the official CPT codebook or a relevant medical billing resource.
- Global Days: This information is not available in the provided source.The global period for this procedure would need to be determined based on local payer guidelines and the specific circumstances of the surgery.
- Payment Status: Active
- Modifier TC rule: Information on TC modifiers is not available in the provided source.
- Fee Schedule: This information is not available in the provided source. Fee schedule data can be obtained from official fee schedules or relevant billing resources.
- Specialties:Vascular Surgery, Hand Surgery
- Place of Service:Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)