How To Use CPT Code 64727

CPT 64727 describes a procedure known as internal neurolysis, which involves the excision of scar tissue within and between nerve fibers in the protective nerve sheath. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64727?

CPT 64727 is a code used to describe the internal neurolysis procedure. During this procedure, a qualified healthcare provider uses an operating microscope and microsurgical techniques to carefully remove scar tissue from within and between nerve fibers in the protective nerve sheath. This procedure is typically performed during the repair of a nerve compression injury to optimize nerve regeneration.

2. Official Description

The official description of CPT code 64727 is: ‘Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis).’ It is important to note that code 69990 should not be reported in addition to code 64727.

3. Procedure

1. Once the patient is appropriately prepped and anesthetized, the healthcare provider makes an incision over the affected nerve.
2. Using an operating microscope and microsurgical techniques, the provider carefully opens the nerve’s outer sheath.
3. Scar tissue within and between the nerve bundles is gently excised.
4. After completing the procedure, the provider closes the skin and subcutaneous layer with sutures.

4. Qualifying circumstances

CPT 64727 is performed when there is a need to remove scar tissue within and between nerve fibers in the protective nerve sheath. This procedure is typically done during the repair of a nerve compression injury. It requires the use of an operating microscope and microsurgical techniques.

5. When to use CPT code 64727

CPT code 64727 should be used when a healthcare provider performs internal neurolysis, requiring the use of an operating microscope. It is important to note that code 64727 should not be reported in addition to code 69990, as they represent different procedures.

6. Documentation requirements

To support a claim for CPT code 64727, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for internal neurolysis
• Details of the procedure, including the use of an operating microscope
• Date of the procedure
• Specific nerve or nerves treated
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 64727, ensure that the procedure meets the requirements for internal neurolysis and the use of an operating microscope. It is important to note that code 64727 should not be reported in addition to code 69990, as they represent different procedures.

8. Historical information

CPT code 64727 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A qualified healthcare provider performs internal neurolysis on a patient with a compressed ulnar nerve.
2. Using an operating microscope, the provider excises scar tissue within and between nerve fibers in the protective nerve sheath of a patient with a compressed median nerve.
3. During a nerve repair surgery, the provider performs internal neurolysis on a patient with a compressed radial nerve.
4. A healthcare provider uses microsurgical techniques and an operating microscope to remove scar tissue within and between nerve fibers in the protective nerve sheath of a patient with a compressed sciatic nerve.
5. Internal neurolysis is performed by a qualified healthcare provider on a patient with a compressed femoral nerve, using an operating microscope and microsurgical techniques.
6. A patient with a compressed tibial nerve undergoes internal neurolysis performed by a qualified healthcare provider using an operating microscope.
7. During a nerve repair surgery, the provider performs internal neurolysis on a patient with a compressed peroneal nerve, requiring the use of an operating microscope.
8. A qualified healthcare provider uses microsurgical techniques and an operating microscope to remove scar tissue within and between nerve fibers in the protective nerve sheath of a patient with a compressed brachial plexus.
9. Internal neurolysis is performed on a patient with a compressed facial nerve by a qualified healthcare provider using an operating microscope.
10. A healthcare provider performs internal neurolysis on a patient with a compressed trigeminal nerve, requiring the use of an operating microscope and microsurgical techniques.