How To Use CPT Code 64820

CPT 64820 describes a procedure that involves the removal or destruction of connections between the digital nerves and digital arteries of the fingers. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64820?

CPT 64820 is a code used to describe a procedure in which the provider removes or destroys connections between the digital nerves and digital arteries of the fingers. This procedure is performed to relieve pain or increase blood flow in cases where the blood vessels are narrowed.

2. Official Description

The official description of CPT code 64820 is: ‘Sympathectomy; digital arteries, each digit.’

3. Procedure

1. When performing CPT 64820, the provider begins by making an incision in the distal palm over the common digital artery.
2. They then extend the dissection into the affected finger, exposing the proper digital artery on both sides of the finger.
3. With the help of loupe magnification or an operating microscope, the provider carefully strips off and excises the adventitial tissue, which is the outermost connective tissue covering the vessel.
4. During the dissection, the provider takes care not to damage or perforate the digital artery and preserves small arterial branches.
5. Once the procedure is complete, the provider closes the incised tissue and skin incision.

4. Qualifying circumstances

CPT 64820 is performed in cases where the patient experiences pain or reduced blood flow due to narrowed blood vessels. The procedure is typically done on the fingers, and the patient must meet the criteria for sympathectomy. It is important to note that CPT code 69990 should not be reported in addition to code 64820.

5. When to use CPT code 64820

CPT code 64820 should be used when the provider performs a sympathectomy on the digital arteries of each digit. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 64820, the provider must document the following information:

• Patient’s diagnosis and the need for sympathectomy
• Details of the procedure, including the specific fingers treated
• Incision site and approach used
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64820, ensure that the procedure meets the criteria outlined in the code description. It is important to follow the specific guidelines for reporting this code and not to report CPT code 69990 in addition to code 64820. Consider any additional services or procedures performed during the same encounter and report them accordingly.

8. Historical information

CPT 64820 was added to the Current Procedural Terminology system on January 1, 1995. There have been historical changes to the code, including a code change on January 1, 2002, which updated the description to include the use of magnification or an operating microscope.

9. Examples

1. A patient with severe pain in their fingers undergoes CPT 64820 to relieve their symptoms.
2. A patient with reduced blood flow in their fingers undergoes CPT 64820 to improve circulation.
3. A provider performs CPT 64820 on a patient with a diagnosed condition that requires sympathectomy.
4. A patient with a history of narrowed blood vessels in their fingers undergoes CPT 64820 to alleviate their symptoms.
5. A provider performs CPT 64820 on a patient who has not responded to other conservative treatments for their finger pain.
6. A patient with a specific medical condition that affects the blood vessels in their fingers undergoes CPT 64820 to improve their quality of life.
7. A provider performs CPT 64820 on a patient who has experienced significant functional impairment due to finger pain.
8. A patient with a diagnosed vascular disorder undergoes CPT 64820 to address their symptoms and improve blood flow.
9. A provider performs CPT 64820 on a patient who has failed to respond to other non-surgical interventions for their finger pain.
10. A patient with a history of finger pain and reduced blood flow undergoes CPT 64820 to alleviate their symptoms and improve their overall hand function.