2025 CPT code 64910
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Repair of a nerve using a synthetic conduit or vein allograft; each nerve repaired.
Modifiers 51 (multiple procedures), 59 (distinct procedural service), and others may be applicable depending on the specific circumstances of the case.Consult the CPT guidelines and payer rules for proper modifier use.
Medical necessity is established by documentation of a clinically significant nerve injury requiring surgical repair to restore function. The documentation must support the need for the specific type of graft used and the number of nerves repaired.The procedure should be deemed medically necessary according to the payer's specific guidelines.
The surgeon is responsible for all aspects of the nerve repair procedure, including preoperative assessment, surgical technique, and postoperative care.
- Surgery
- Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System; Neurorrhaphy With Nerve Graft, Vein Graft or Conduit Procedures
In simple words: The doctor fixes a damaged nerve using a tiny artificial tube or a piece of vein to reconnect the broken ends.This is done under a microscope using very small stitches.
This procedure involves repairing a damaged nerve using a synthetic tube or a vein graft (from a living donor or cadaver) to bridge the gap between the severed nerve ends.The surgeon makes an incision, exposes the damaged nerve, removes the damaged section, measures the gap, selects an appropriately sized conduit or graft, and places it in the gap. Microsurgical techniques are used to suture the proximal and distal nerve ends within the conduit. The wound is then closed.The code is reported for each nerve repaired.
Example 1: A patient presents with a laceration to their forearm resulting in a severed median nerve.The surgeon performs nerve repair using a synthetic conduit., During a hand surgery, the surgeon discovers a transected ulnar nerve. The surgeon repairs this nerve with a vein allograft., A patient with a traumatic brachial plexus injury undergoes surgery to repair multiple nerves with a combination of conduits and allografts.Multiple units of 64910 may be reported in this scenario, with appropriate modifiers if necessary.
Detailed operative report including specifics on the nerve(s) repaired, type of graft used (synthetic conduit, vein allograft, etc.), graft dimensions, and surgical technique. Preoperative and postoperative imaging (if applicable) and neurological assessment documenting nerve function before and after the procedure.
** Accurate coding requires detailed documentation to support medical necessity and the specific type and number of nerves repaired.Always consult with your payer for specific coding and reimbursement guidelines.The use of allografts and the specifics of the procedure should be documented thoroughly.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: The RVUs vary depending on the payer and the specific circumstances of the procedure.Check with your specific payer for the most up-to-date RVU values.One source lists 22.98 RVUs for this code in 2024.
- Global Days: The global period is not specified for this code.Refer to payer-specific guidelines for appropriate global period definitions.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this code.
- Fee Schedule: Historical fee schedules vary depending on payer and location.Specific information on historical fee schedules is not available here.
- Specialties:Neurosurgery, Plastic Surgery, Hand Surgery, Orthopedic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center