2025 CPT code 64868

Anastomosis; facial-hypoglossal. This procedure involves surgically connecting the facial nerve to the hypoglossal nerve to restore facial motor function.

This code is specific for facial-hypoglossal anastomosis.Other nerve anastomosis or grafts would use different codes.Modifiers may be applicable in certain circumstances, such as increased procedural services or multiple procedures performed.

Modifiers may apply depending on the specific circumstances of the procedure. The documentation should clearly indicate the need for any modifiers used.

Medical necessity is established by documentation of significant facial paralysis impacting function or quality of life and failure of conservative treatments. The procedure should aim to improve function, such as restoring the ability to close the eye, smile, or speak clearly.

The surgeon is responsible for the entire procedure, from prepping and anesthetizing the patient to making the incision, identifying and preparing the nerves, suturing them together, and closing the wound. They must use high-power magnification and take great care to avoid injuring surrounding structures.

In simple words: This surgery connects the facial nerve to the tongue nerve to help restore movement in the face after paralysis. The surgeon makes a cut in the neck, finds the facial and tongue nerves, and carefully stitches them together. This allows signals from the tongue nerve to reach the facial muscles and help them move again.

Surgical anastomosis of the facial nerve and the hypoglossal nerve. This procedure is performed to restore facial motor function that has been lost due to a tumor, injury, or other condition causing paralysis.The surgeon makes an incision in the neck to access the facial and hypoglossal nerves. The hypoglossal nerve is identified, often by stimulation, and then carefully dissected. The facial nerve is similarly prepared. The two nerves are then sutured together to create a connection that allows nerve impulses to be transferred from the hypoglossal nerve to the facial muscles.

Example 1: A patient with facial paralysis due to a tumor removal undergoes a facial-hypoglossal nerve anastomosis to restore facial movement., A patient who suffered facial nerve damage in a car accident undergoes this procedure to regain facial muscle control., A patient with Bell's palsy that hasn't resolved with other treatments undergoes this surgery to improve facial symmetry and function.

Documentation should include details of the cause of facial paralysis, the extent of the paralysis, prior treatments, operative report detailing the procedure, and post-operative progress.

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