How To Use CPT Code 64802

CPT 64802 describes a procedure known as sympathectomy, specifically targeting the cervical sympathetic nerve. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64802?

CPT 64802 is a code used to describe a surgical procedure that involves the removal or destruction of a portion of the cervical sympathetic nerve. This nerve is part of the sympathetic nerve chain and plays a role in controlling involuntary body functions such as heart rate, breathing, sweating, and digestion. The procedure aims to relieve pain or increase blood flow in patients with narrowed blood vessels.

2. Official Description

The official description of CPT code 64802 is: ‘Sympathectomy, cervical.’ This code represents the surgical removal or destruction of a portion of the cervical sympathetic nerve. If the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. When performing CPT 64802, the provider begins by making an incision in the neck above the clavicle.
2. Next, the provider locates and identifies the cervical sympathetic chain, which is a thick, cord-like structure that passes across the first or second rib.
3. The provider carefully elevates and exposes the sympathetic chain, ensuring to avoid surrounding structures.
4. Using surgical techniques, the provider resects or destroys a part of the nerve chain, specifically dividing the nerve connections to the cervical sympathetic ganglion.
5. Finally, the provider closes the incised tissue and skin incision to complete the procedure.

4. Qualifying circumstances

CPT 64802 is typically performed on patients who experience pain or have narrowed blood vessels that can benefit from the removal or destruction of a portion of the cervical sympathetic nerve. It is important to note that this procedure is unilateral, meaning it is performed on one side of the body. If the procedure is performed bilaterally, modifier 50 should be appended to the code.

5. When to use CPT code 64802

CPT code 64802 should be used when a provider performs a sympathectomy specifically targeting the cervical sympathetic nerve. It is important to ensure that the procedure is performed on the appropriate side of the body and that modifier 50 is appended if the procedure is performed bilaterally.

6. Documentation requirements

To support a claim for CPT 64802, the provider must document the following information:

• Patient’s diagnosis and the need for the sympathectomy
• Details of the procedure, including the specific portion of the cervical sympathetic nerve that was removed or destroyed
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64802, it is important to ensure that the procedure is performed on the appropriate side of the body. If the procedure is performed bilaterally, modifier 50 should be appended to the code. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 64802 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 patient with chronic pain undergoes a sympathectomy targeting the cervical sympathetic nerve to alleviate their symptoms.
2. A patient with narrowed blood vessels undergoes a sympathectomy targeting the cervical sympathetic nerve to improve blood flow.
3. A patient with excessive sweating undergoes a sympathectomy targeting the cervical sympathetic nerve to reduce sweat production.
4. A patient with digestive issues undergoes a sympathectomy targeting the cervical sympathetic nerve to improve digestion.
5. A patient with a rapid heart rate undergoes a sympathectomy targeting the cervical sympathetic nerve to regulate their heart rate.
6. A patient with Raynaud’s disease undergoes a sympathectomy targeting the cervical sympathetic nerve to improve blood circulation.
7. A patient with complex regional pain syndrome undergoes a sympathectomy targeting the cervical sympathetic nerve to alleviate their symptoms.
8. A patient with vasospastic disorders undergoes a sympathectomy targeting the cervical sympathetic nerve to improve blood flow.
9. A patient with hyperhidrosis undergoes a sympathectomy targeting the cervical sympathetic nerve to reduce excessive sweating.
10. A patient with hypertension undergoes a sympathectomy targeting the cervical sympathetic nerve to regulate their blood pressure.