2025 CPT code 64874

Suture of nerve requiring extensive mobilization or transposition. This code is used in conjunction with primary codes 64831-64865.

Code 64874 is used to report the additional work involved in extensive mobilization or transposition of a nerve during a neurorrhaphy. It is not reported for simple freeing of the nerve ends. The primary neurorrhaphy code describes the actual repair of the nerve.

Modifiers may be applicable to the primary procedure code but generally not to add-on codes like 64874.Refer to specific payer guidelines for modifier usage.

Medical necessity is established by the underlying condition requiring nerve repair, such as trauma, laceration, or tumor resection. The documentation should clearly demonstrate the need for extensive mobilization or transposition of the nerve to achieve a tension-free repair and restore nerve function.

The physician performs the surgical repair of the nerve, mobilizing and/or transposing the nerve to achieve a tension-free repair while preserving essential vascular supply and nerve branches. This may involve freeing the nerve from surrounding tissues and repositioning it.

In simple words: This procedure involves repositioning a damaged nerve to allow it to be repaired without being stretched too tight.It’s used when a nerve has been injured and needs to be stitched back together, but the ends are too far apart. The surgeon carefully moves the nerve to reduce the gap and then repairs it.

Repair of a nerve requiring extensive mobilization or transposition of the nerve to overcome a gap or tension. This often involves freeing the nerve from surrounding tissues and repositioning it to facilitate tension-free repair, taking care to protect essential nerve branches and blood vessels. This code is an add-on code and should be reported in addition to the primary nerve suture code (64831-64865).

Example 1: A patient sustained a deep laceration to the forearm, severing the median nerve. During surgical exploration, the nerve ends are found to be too far apart for direct repair. The surgeon performs extensive mobilization of the nerve, freeing it from surrounding tissues, to allow for tension-free suturing of the nerve ends. Code 64874 is reported in addition to the primary nerve repair code., A patient with a previous nerve injury has developed a painful neuroma.The surgeon performs transposition of the nerve, moving it to a new location to relieve tension and reduce pain, followed by neurorrhaphy. Code 64874 is reported in addition to the primary nerve repair code., During a tumor resection, a segment of a nerve is removed. To bridge the resulting gap, the surgeon performs transposition of the nerve to bring the ends closer together for a tension-free repair. Code 64874 is reported in addition to the primary nerve repair code.

Documentation should include details of the nerve injury, the extent of mobilization or transposition performed, the method of nerve repair, and any associated procedures. Operative notes should clearly describe the complexity of the mobilization or transposition and the reason it was necessary.

** This code describes an intraoperative procedure performed to facilitate nerve repair, not a separate stand-alone procedure. It's essential to correctly pair this code with the primary nerve repair code and accurately document the complexity of the nerve mobilization or transposition.

  • Payment Status: Active
  • Modifier TC rule: Not applicable to add-on codes.
  • Specialties:Plastic Surgery, Orthopedic Surgery, Neurosurgery, Hand Surgery, General Surgery
  • Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient, Physician's Office
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