2025 CPT code 64859
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Repair of additional peripheral nerve(s); add-on code.
Modifiers such as 51 (multiple procedures), 52 (reduced services), and others may be applicable depending on the specific circumstances of the surgical procedure.
Medical necessity is established by documenting the presence of demonstrable peripheral nerve damage requiring surgical repair.The extent of the damage, functional deficits, and the clinical need for repair must be clearly documented.
The surgeon's responsibility includes prepping the patient, making an incision (or working through an existing wound), locating the damaged nerve(s), preparing the nerve ends for repair, aligning the nerve ends, suturing the nerve(s) together, potentially reconstructing the nerve(s), and closing the incision.
In simple words: This code is for fixing extra damaged nerves in the body, often caused by injury or disease.It's an add-on; you'll need another code for the main nerve repair.
This CPT code 64859 represents an add-on code for the repair of damage to additional peripheral nerves.The procedure involves locating the damaged nerve, cleaning the nerve ends, aligning them, and suturing them together. Additional sutures may be needed depending on nerve size. Nerve reconstruction and wound closure may also be performed. This code is used in addition to the primary nerve repair code.
Example 1: A patient sustains a severe laceration to their arm involving significant damage to multiple peripheral nerves.The surgeon repairs the main nerve using a primary CPT code and utilizes 64859 to report the repair of two additional smaller branches of the same nerve., During a surgical procedure for a carpal tunnel release, the surgeon discovers and repairs an additional ulnar nerve injury. The main carpal tunnel release is coded separately, and 64859 is added to bill for the unexpected ulnar nerve repair., A patient presents with multiple lacerations across the forearm from a motorcycle accident, requiring repair of the median, ulnar, and radial nerves. The main repair of the median nerve is coded separately, with 64859 used to add on the repair of the ulnar and radial nerves.
** This is an add-on code and should only be reported when additional peripheral nerves are repaired.The documentation must clearly indicate the number of additional nerves repaired to justify the use of this code.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: The RVUs for this code will vary based on geographic location, facility type (non-facility vs. facility), and other factors.Consult a relevant fee schedule for current values.
- Global Days : The global period is not specified for this add-on code.The global period would be determined by the primary procedure code.
- Payment Status: Active
- Modifier TC rule: The application of a TC modifier (Technical Component) depends on the primary procedure code and the specific circumstances. This add-on code does not include a TC modifier intrinsically.
- Fee Schedule : Historical fee schedules are not available here but can be obtained from CMS or private payer websites.These would reflect historical reimbursement rates and would vary based on location and other factors.
- Specialties:Neurosurgery, Orthopedic Surgery, Plastic Surgery, Hand Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center