How To Use CPT Code 64795

CPT 64795 describes the procedure for a nerve biopsy, which involves the excision or removal of a small sample of a nerve for laboratory examination. 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 64795?

CPT 64795 can be used to describe the excision or removal of a small sample of a nerve for laboratory examination. This procedure is performed to help diagnose conditions such as nerve damage, degeneration, or inflammatory nerve conditions. The provider will incise the skin over the location of the nerve to be biopsied and continue until they expose the nerve. There are three types of nerve biopsies that may be performed, depending on the location of the problem: sensory nerve biopsy, selective motor nerve biopsy, or fascicular biopsy.

2. Official Description

The official description of CPT code 64795 is: ‘Biopsy of nerve.’

3. Procedure

1. When the patient is appropriately prepped and anesthetized, the provider incises the skin over the location of the nerve to be biopsied.
2. The provider continues the incision until they expose the nerve.
3. Depending on the location of the problem, the provider may perform a sensory nerve biopsy, selective motor nerve biopsy, or fascicular biopsy.
4. In a sensory nerve biopsy, the provider excises a small, usually one-inch piece of an affected nerve under loupe magnification or an operating microscope.
5. If there is any concern about a loss of function, the provider will use electrical stimulation to test the fascicles and may harvest and suture nerve grafts as necessary.
6. Once the procedure is complete, the provider closes the tissue and the skin.

4. Qualifying circumstances

CPT 64795 is performed when there is a need to diagnose conditions such as nerve damage, degeneration, or inflammatory nerve conditions. The procedure is typically performed by a provider who is experienced in nerve biopsies and has the necessary skills and knowledge to perform the procedure safely and effectively.

5. When to use CPT code 64795

CPT code 64795 should be used when a provider performs a nerve biopsy to obtain a small sample of a nerve for laboratory examination. This code is appropriate when the biopsy is performed to help diagnose conditions related to nerve damage, degeneration, or inflammatory nerve conditions.

6. Documentation requirements

To support a claim for CPT 64795, the provider must document the following information:

• Patient’s diagnosis or symptoms indicating the need for a nerve biopsy
• Details of the procedure, including the location of the nerve, the type of biopsy performed, and any additional procedures performed (such as nerve grafting)
• Any complications or adverse events that occurred during or after the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64795, ensure that the procedure meets the criteria for a nerve biopsy. The provider should document the necessary information to support the medical necessity of the procedure. It is important to follow the specific guidelines provided by the payer to ensure accurate and appropriate billing for CPT 64795.

8. Historical information

CPT 64795 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 a nerve biopsy on a patient with symptoms of peripheral neuropathy to determine the cause of their condition.
2. A patient presents with chronic pain in their arm, and a provider performs a nerve biopsy to investigate potential nerve damage or inflammation.
3. A provider performs a nerve biopsy on a patient with suspected nerve entrapment syndrome to confirm the diagnosis and guide treatment.
4. A patient with symptoms of a neurofibroma undergoes a nerve biopsy to obtain a tissue sample for further examination.
5. A provider performs a nerve biopsy on a patient with suspected nerve degeneration to assess the extent of the damage and plan appropriate interventions.
6. A patient with symptoms of a schwannoma undergoes a nerve biopsy to confirm the diagnosis and determine the best course of treatment.
7. A provider performs a nerve biopsy on a patient with unexplained muscle weakness to investigate potential nerve-related causes.
8. A patient with symptoms of inflammatory neuropathy undergoes a nerve biopsy to help guide the selection of appropriate medications and therapies.
9. A provider performs a nerve biopsy on a patient with suspected nerve compression to determine the underlying cause and plan appropriate interventions.
10. A patient with symptoms of a nerve tumor undergoes a nerve biopsy to obtain a tissue sample for further examination and to guide treatment decisions.