How To Use CPT Code 64746

CPT 64746 describes the transection or avulsion of the phrenic nerve, which is responsible for controlling the function of the diaphragm muscle important for breathing. 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 64746?

CPT 64746 is used to describe the surgical procedure of transecting or avulsing the phrenic nerve. This procedure involves severing or removing a portion of the nerve, which results in paralysis of the diaphragm on one side. It may be performed during extended thoracic surgeries to collapse a diseased lung or to replace or repair a damaged or diseased nerve.

2. Official Description

The official description of CPT code 64746 is the transection or avulsion of the phrenic nerve. Avulsion refers to forcibly pulling or tearing away, while transection means dividing by cutting across. The phrenic nerve is one of a pair of nerves that extend from the neck to the lungs and controls the function of the diaphragm muscle.

3. Procedure

1. When performing CPT 64746, the patient is appropriately prepped and anesthetized.
2. The provider makes an incision on the side of the neck, just above the collarbone, to expose the phrenic nerve.
3. The phrenic nerve is identified, and the provider proceeds to either divide or avulse the nerve.
4. The resulting effect of the procedure is visualized, and the wound is closed, followed by the application of appropriate dressings.

4. Qualifying circumstances

CPT 64746 is typically performed during thoracic surgeries or procedures where collapsing a diseased lung or repairing a damaged or diseased phrenic nerve is necessary. The procedure is reserved for cases where other treatment options have been exhausted, and the benefits outweigh the risks. It is important to note that only qualified healthcare professionals should perform this procedure.

5. When to use CPT code 64746

CPT code 64746 should be used when the transection or avulsion of the phrenic nerve is performed during a surgical procedure. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition. This code should not be used for any other procedures or services unrelated to the transection or avulsion of the phrenic nerve.

6. Documentation requirements

To support a claim for CPT 64746, the healthcare professional must document the following information:

• Reason for performing the procedure and the patient’s condition
• Details of the surgical procedure, including the approach used
• Extent of the transection or avulsion of the phrenic nerve
• Visual confirmation of the resulting effect
• Date of the procedure
• Signature of the performing healthcare professional

7. Billing guidelines

When billing for CPT 64746, it is important to ensure that the procedure is performed by a qualified healthcare professional and is appropriately documented. This code should not be reported with other codes unless they are directly related to the transection or avulsion of the phrenic nerve. It is crucial to follow the specific guidelines provided by the payer and to use the appropriate modifiers if required.

8. Historical information

CPT 64746 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoing thoracic surgery has their phrenic nerve transected to collapse a diseased lung.
2. A patient with a damaged phrenic nerve undergoes a surgical procedure to repair the nerve.
3. During a thoracic surgery, the phrenic nerve is avulsed to facilitate the removal of a tumor.
4. A patient with a diseased phrenic nerve undergoes a surgical procedure to replace the damaged nerve.
5. During a thoracic surgery, the phrenic nerve is transected to improve access to the surgical site.
6. A patient with a paralyzed diaphragm undergoes a surgical procedure to avulse the phrenic nerve on the affected side.
7. During a thoracic surgery, the phrenic nerve is transected to allow for the resection of a portion of the lung.
8. A patient with a damaged phrenic nerve undergoes a surgical procedure to avulse the nerve and prevent further complications.
9. During a thoracic surgery, the phrenic nerve is transected to facilitate the repair of a congenital abnormality.
10. A patient with a paralyzed diaphragm undergoes a surgical procedure to avulse the phrenic nerve and improve breathing function.