How To Use CPT Code 64788

CPT 64788 describes the excision of a neurofibroma or neurolemmoma along a cutaneous nerve. 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 64788?

CPT 64788 can be used to describe the excision of a tumor that is located just under the skin and growing along a cutaneous nerve. The procedure involves removing the tumor from the nerve while preserving the nerve if possible.

2. Official Description

The official description of CPT code 64788 is: ‘Excision of neurofibroma or neurolemmoma; cutaneous nerve.’

3. Procedure

1. The provider begins by making an incision over the location of the tumor and continues until the nerve is exposed.
2. Using magnification tools such as loupe magnification or an operating microscope, the provider opens the cutaneous nerve and inspects the fascicles and tumor.
3. If the tumor is enveloped with fascicles, the provider carefully separates and elevates the fascicles from the tumor.
4. The provider then removes the tumor from the nerve, taking care to preserve the nerve if possible.
5. If the tumor cannot be completely excised from the nerve, the provider may need to excise the nerve fascicle while preserving the remaining nerve fascicles to maintain nerve function.
6. Once the excision is complete, the provider closes the tissue and the skin.

4. Qualifying circumstances

CPT 64788 is performed when there is a tumor present within the nerve sheath that displaces the fascicles. The procedure is typically done on patients who have a neurofibroma or neurolemmoma along a cutaneous nerve. The provider must carefully evaluate the patient’s condition and determine the need for excision of the tumor.

5. When to use CPT code 64788

CPT code 64788 should be used when a provider performs the excision of a neurofibroma or neurolemmoma along a cutaneous nerve. It is important to accurately document the procedure and ensure that the excision is performed on the specified nerve.

6. Documentation requirements

To support a claim for CPT 64788, the provider must document the following information:

• Patient’s diagnosis and the presence of a neurofibroma or neurolemmoma
• Location of the tumor along the cutaneous nerve
• Details of the procedure, including the incision, exposure of the nerve, separation of fascicles, tumor removal, and preservation of the nerve if possible
• Closure of the tissue and skin
• Any complications or additional procedures performed
• Signature of the provider performing the excision

7. Billing guidelines

When billing for CPT 64788, ensure that the excision is performed along a cutaneous nerve and that the documentation supports the procedure. It is important to follow the specific guidelines for reporting this code and any associated modifiers. CPT code 64788 should not be reported with other codes unless additional procedures were performed during the same session.

8. Historical information

CPT 64788 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 provider performs the excision of a neurofibroma along a cutaneous nerve on a patient’s arm.
2. A surgeon removes a neurolemmoma from a cutaneous nerve on a patient’s leg.
3. A neurologist excises a tumor from a cutaneous nerve on a patient’s face.
4. A plastic surgeon performs the excision of a neurofibroma along a cutaneous nerve on a patient’s back.
5. An orthopedic surgeon removes a neurolemmoma from a cutaneous nerve on a patient’s hand.
6. A dermatologist excises a tumor from a cutaneous nerve on a patient’s scalp.
7. A neurosurgeon performs the excision of a neurofibroma along a cutaneous nerve on a patient’s neck.
8. A hand surgeon removes a neurolemmoma from a cutaneous nerve on a patient’s finger.
9. A podiatrist excises a tumor from a cutaneous nerve on a patient’s foot.
10. A plastic surgeon performs the excision of a neurofibroma along a cutaneous nerve on a patient’s chest.