2025 CPT code 64898
(Active) Effective Date: N/A Revision Date: N/A Surgery - Neurorrhaphy With Nerve Graft Surgical Procedures on the Nervous System Feed
Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length.
Modifiers may apply depending on the specifics of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural service, 22 for increased procedural services). Consult your payer for allowed modifiers.
Medical necessity is established when the nerve injury significantly impacts the patient's sensory or motor function, and the nerve graft procedure is deemed the most appropriate surgical approach to restore function and minimize long-term disability.Justification should be clearly documented in the medical record.
The surgeon is responsible for pre-operative assessment, obtaining informed consent, performing the nerve graft procedure (including graft harvest and microsurgical repair), post-operative care, and follow-up assessments.
- Surgical Procedures on the Nervous System
- Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System
In simple words: This surgery repairs a damaged nerve in your arm or leg. The surgeon uses a piece of healthy nerve from another part of your body to bridge the damaged area and help the nerve heal. This piece of nerve is longer than 4 centimeters.The surgeon uses microsurgery tools for a precise repair.
This procedure involves repairing a damaged nerve in an arm or leg using a multiple-strand nerve graft (cable graft) exceeding 4 cm in length.The procedure includes harvesting the graft from a donor nerve (commonly the sural nerve), meticulous microsurgical repair of the injured nerve by rejoining individual nerve bundles, and closure of both the donor and recipient sites.The surgeon uses a microsurgical technique to precisely reconnect the individual nerve bundles within the nerve, using the graft to bridge the gap. The sural nerve, superficial radial sensory nerve, and medial antebrachial cutaneous nerve are common donor nerves. The surgeon typically prefers the sural nerve due to its superior nerve tissue quality.
Example 1: A patient presents with a severed median nerve in their forearm due to a deep laceration.A 6cm sural nerve graft is used for neurorrhaphy., A patient sustains a crush injury to their brachial plexus, resulting in significant nerve damage. Multiple nerve grafts, including one exceeding 4cm and necessitating code 64898, are used for reconstruction., A patient has a traumatic nerve injury to the peroneal nerve in their leg. The use of a 5cm sural nerve graft, employing the cable graft technique, is necessary to bridge the nerve gap.
* Detailed operative report describing the location and extent of the nerve injury, the type and length of the graft, the microsurgical technique used, and the details of the donor site harvest.* Preoperative and postoperative neurological examinations documenting the sensory and motor deficits before and after surgery.* Imaging studies (e.g., MRI or ultrasound) to assess the extent of the nerve injury.* Pathology report if any tissue was removed.* Photographs of the surgical site, before, during, and after the procedure (optional).
** This code specifically addresses nerve grafts over 4 cm.Shorter grafts would require different coding. The choice of donor nerve depends on factors such as the length of the graft needed and the location of the injured nerve. Always confirm appropriate coding with your local payer.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: Information not available in provided sources.Consult current RVU data for accurate values.
- Global Days: Information not available in provided sources.Global surgical days vary depending on payer and specific circumstances.Consult payer guidelines for accurate information.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier may be applicable depending on the payer and the circumstances of the service delivery.
- Fee Schedule: Information not available in provided sources. Consult historical fee schedules from relevant payers.
- Specialties:Neurosurgery, Plastic Surgery, Orthopedic Surgery, Hand Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center