2025 CPT code 64876
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Surgery Feed
Suture of nerve requiring shortening of bone of extremity.
Modifiers may be applicable to 64876 to indicate specific circumstances of the procedure, such as reduced services (modifier 52), or unusual non-overlapping service (modifier XU).
Medical necessity for 64876 is established when the nerve gap is too large for primary repair without undue tension. The bone shortening procedure is necessary to facilitate a tension-free nerve repair and improve the chances of nerve regeneration and functional recovery.
During repair of a nerve at the same session, the provider overcomes a large nerve gap, also referred to as a segmental defect, by excising a portion of an adjacent bone to allow a direct non–tension suture of the nerve ends. He frees the nerve ends if necessary from surrounding structures to release the nerve ends to complete a tension–free repair. He then completes the nerve repair and closes the wound.
In simple words: This procedure involves repairing a damaged nerve by shortening a nearby bone to reduce tension on the nerve, allowing the ends to be reconnected.
The provider repairs a portion of a nerve that is too short and can’t reconnect without tension by excising part of a nearby bone to create length in the injured nerve to connect the nerve ends. During repair of a nerve at the same session, the provider overcomes a large nerve gap, also referred to as a segmental defect, by excising a portion of an adjacent bone to allow a direct non–tension suture of the nerve ends. He frees the nerve ends if necessary from surrounding structures to release the nerve ends to complete a tension–free repair. He then completes the nerve repair and closes the wound.
Example 1: A patient sustained a deep laceration to their forearm, severing the median nerve and resulting in a nerve gap too large to repair directly. The surgeon performs a neurorrhaphy and shortens the radius bone to bridge the gap and allow for tension-free nerve repair. Code 64876 is reported in addition to the primary nerve repair code., During a surgical procedure to remove a tumor from a patient's leg, the peroneal nerve was damaged, creating a segmental defect. To repair the nerve, the surgeon excised a portion of the fibula, allowing for a tension-free neurorrhaphy. Code 64876 is used in conjunction with the primary nerve repair code., A patient with a traumatic injury to their upper arm resulted in a significant brachial plexus nerve injury with a large gap. The surgeon performed a complex nerve reconstruction, including shortening the humerus bone to facilitate the neurorrhaphy of the affected nerves. Code 64876 is reported along with the appropriate primary nerve repair code(s).
Documentation should include details of the nerve injury, the size of the nerve gap, the bone shortening procedure performed, the type of neurorrhaphy, and any associated procedures.
** This code is always reported in addition to the primary nerve repair code.
- Specialties:Plastic Surgery, Orthopedic Surgery, Hand Surgery, Neurosurgery, Peripheral Nerve Surgery.
- Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient, Physician's Office.