How To Use CPT Code 64778

CPT 64778 describes the excision of a neuroma on a digital nerve in a different finger or toe, following the removal of an initial neuroma during the same session. 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 64778?

CPT 64778 can be used to describe the excision of a neuroma on a digital nerve in a different finger or toe, after the removal of an initial neuroma during the same session. This code is used when the provider removes another tumor or mass growing on a peripheral nerve in a separate digit, following the removal of the initial neuroma.

2. Official Description

The official description of CPT code 64778 is: ‘Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 64776.

3. Procedure

1. The provider incises the skin over the location of the additional digital neuroma in a different finger or toe.
2. They expose the neuroma and carefully dissect it free from the surrounding tissue.
3. The provider then excises the neuroma, removing the tumor or mass growing from the digital nerve.
4. Finally, they close the tissue and skin to complete the procedure.

4. Qualifying circumstances

CPT 64778 is used when there is an additional neuroma found on a different finger or toe, following the removal of an initial neuroma during the same session. A neuroma is a tumor or mass growing from a nerve, and in this case, it occurs on a digital nerve. The procedure is performed on the peripheral nerves outside the brain and spinal cord.

5. When to use CPT code 64778

CPT code 64778 should be used when there is a need to excise an additional neuroma on a digital nerve in a different finger or toe, after the removal of an initial neuroma during the same session. This code should not be reported without an appropriate primary code, which is CPT code 64776.

6. Documentation requirements

To support a claim for CPT 64778, the provider must document the following information:

• Identification of the initial neuroma that was removed during the same session
• Location of the additional digital neuroma in a different finger or toe
• Description of the procedure performed to excise the neuroma
• Details of the closure of the tissue and skin

7. Billing guidelines

When billing for CPT 64778, ensure that the procedure is performed on a different finger or toe after the removal of an initial neuroma during the same session. This code should be reported in addition to the primary procedure code, which is CPT 64776. Payers will not reimburse for CPT 64778 if it is reported without an appropriate primary code.

8. Historical information

CPT 64778 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 surgeon removes an initial neuroma on the digital nerve of the thumb during a surgical session. They then identify and excise an additional neuroma on the digital nerve of the index finger.
2. Following the removal of an initial neuroma on the digital nerve of the big toe, a podiatrist discovers and removes an additional neuroma on the digital nerve of the second toe.
3. During a procedure to remove an initial neuroma on the digital nerve of the ring finger, a hand surgeon identifies and excises an additional neuroma on the digital nerve of the pinky finger.
4. After removing an initial neuroma on the digital nerve of the middle finger, an orthopedic surgeon discovers and excises an additional neuroma on the digital nerve of the index finger.
5. A plastic surgeon removes an initial neuroma on the digital nerve of the little toe and identifies and excises an additional neuroma on the digital nerve of the fourth toe during the same session.
6. Following the removal of an initial neuroma on the digital nerve of the thumb, a hand surgeon discovers and excises an additional neuroma on the digital nerve of the middle finger.
7. During a surgical procedure to remove an initial neuroma on the digital nerve of the index finger, a hand surgeon identifies and excises an additional neuroma on the digital nerve of the ring finger.
8. After removing an initial neuroma on the digital nerve of the big toe, a podiatrist discovers and excises an additional neuroma on the digital nerve of the third toe.
9. A surgeon removes an initial neuroma on the digital nerve of the pinky finger and identifies and excises an additional neuroma on the digital nerve of the thumb during the same session.
10. Following the removal of an initial neuroma on the digital nerve of the middle finger, an orthopedic surgeon discovers and excises an additional neuroma on the digital nerve of the index finger.