How To Use CPT Code 64792

CPT 64792 describes the excision of an extensive neurofibroma or neurolemmoma, including the malignant type. 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 64792?

CPT 64792 can be used to describe the excision of an extensive neurofibroma or neurolemmoma, including the malignant type. This code is used when a provider removes a tumor that is growing along or in the nerve sheath of a nerve.

2. Official Description

The official description of CPT code 64792 is: ‘Excision of neurofibroma or neurolemmoma; extensive (including malignant type)’. Please note that for the destruction of extensive cutaneous neurofibroma, a different code should be used.

3. Procedure

1. The provider begins by preparing and anesthetizing the patient appropriately.
2. An incision is made over the location of the tumor, and the provider continues until the nerve is exposed.
3. Using loupe magnification or an operating microscope, the provider opens the nerve and inspects the fascicles and tumor.
4. If the tumor is enveloped with fascicles, the provider attempts to separate and elevate the fascicles from the tumor.
5. The tumor is carefully removed from the nerve, with the goal of preserving the nerve if possible.
6. In cases where the tumor is extensive and intertwined with the fascicles, complete removal may not be possible.
7. If the tumor cannot be excised from the nerve, the provider may cautiously excise the affected nerve fascicle, making every effort to preserve the remaining nerve fascicles.
8. Depending on the tumor location, the provider may choose to debulk the tumor to enhance the effectiveness of chemotherapy or radiation treatment.
9. If there is a concern about a loss of function, the provider may use electrical stimulation to test the affected fascicles and may harvest and suture nerve grafts as necessary.
10. Once the procedure is complete, the provider closes the tissue and the skin.

4. Qualifying circumstances

Patients who may require CPT 64792 are those with an extensive neurofibroma or neurolemmoma, including the malignant type, growing along or in the nerve sheath of a nerve. The provider must carefully assess the patient’s condition and determine the need for excision. It is important to note that this code is specifically for extensive tumors and should not be used for the destruction of extensive cutaneous neurofibroma.

5. When to use CPT code 64792

CPT code 64792 should be used when a provider performs the excision of an extensive neurofibroma or neurolemmoma, including the malignant type. It is important to accurately document the extent of the tumor and its location to support the use of this code.

6. Documentation requirements

To support a claim for CPT 64792, the provider must document the following information:

• Patient’s diagnosis and the need for excision
• Details of the procedure, including the location and extent of the tumor
• Use of loupe magnification or an operating microscope
• Efforts made to separate and elevate fascicles from the tumor
• Extent of tumor removal and preservation of the nerve
• Use of electrical stimulation and nerve grafts, if applicable
• Date of the procedure
• Signature of the provider

7. Billing guidelines

When billing for CPT 64792, ensure that the excision is performed for an extensive neurofibroma or neurolemmoma, including the malignant type. It is important to accurately document the procedure and provide the necessary supporting documentation. There are no specific guidelines regarding reporting CPT 64792 with other codes, but it is essential to follow the appropriate coding guidelines and ensure accurate reporting.

8. Historical information

CPT 64792 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 an extensive neurofibroma along the nerve sheath of a patient’s arm.
2. A patient presents with an extensive neurolemmoma growing within the nerve sheath of their leg, and a provider performs the excision.
3. A provider removes an extensive malignant neurofibroma from the nerve sheath of a patient’s back.
4. An extensive neurolemmoma is discovered along the nerve sheath of a patient’s face, and a provider performs the excision.
5. A provider performs the excision of an extensive neurofibroma growing within the nerve sheath of a patient’s abdomen.
6. An extensive malignant neurolemmoma is found along the nerve sheath of a patient’s neck, and a provider performs the excision.
7. A provider removes an extensive neurofibroma from the nerve sheath of a patient’s hand.
8. An extensive neurolemmoma is discovered along the nerve sheath of a patient’s foot, and a provider performs the excision.
9. A provider performs the excision of an extensive malignant neurofibroma growing within the nerve sheath of a patient’s head.
10. An extensive neurolemmoma is found along the nerve sheath of a patient’s chest, and a provider performs the excision.