How To Use CPT Code 64822

CPT 64822 describes a procedure involving the removal or destruction of sympathetic nerves of the ulnar artery. 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 64822?

CPT 64822 is used to describe a procedure in which the provider removes or destroys the sympathetic nerves of the ulnar artery. This procedure is performed to relieve pain or increase blood flow in patients with narrowed blood vessels.

2. Official Description

The official description of CPT code 64822 is: ‘Sympathectomy; ulnar artery.’

3. Procedure

1. The provider begins by prepping and anesthetizing the patient.
2. An incision is made directly over the ulnar artery, extending down to the ulnar canal.
3. The ulnar artery is identified and isolated.
4. The provider carefully strips off and excises the adventitial tissue, which contains the sympathetic nerves that circle the vessel.
5. The dissection is carried out using loupe magnification to ensure precision and to avoid injury to the ulnar artery and surrounding structures.
6. Small branches of the vessel are controlled and cauterized along the way.
7. After completing the procedure, the incised tissue and skin incision are irrigated and closed.

4. Qualifying circumstances

CPT 64822 is performed on patients who require relief from pain or increased blood flow due to narrowed blood vessels. The procedure involves the removal or destruction of sympathetic nerves of the ulnar artery. It is important to note that CPT code 69990 should not be reported in addition to code 64822.

5. When to use CPT code 64822

CPT code 64822 should be used when the provider performs a sympathectomy on the ulnar artery to relieve pain or increase blood flow. It is important to ensure that the procedure is performed on the ulnar artery specifically and not on the radial artery, which has a separate CPT code (64821) for sympathectomy.

6. Documentation requirements

To support a claim for CPT 64822, the provider must document the following information:

• Patient’s diagnosis and the need for sympathectomy
• Details of the procedure, including the incision, identification and isolation of the ulnar artery, excision of the adventitial tissue, and any complications encountered
• Date of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64822, ensure that the procedure involves the removal or destruction of sympathetic nerves of the ulnar artery. It is important to note that CPT code 69990 should not be reported in addition to code 64822. Additionally, consider any specific guidelines provided by the payer regarding the use of this code.

8. Historical information

CPT 64822 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates to the code since its addition.

9. Examples

1. A patient with narrowed blood vessels undergoes a sympathectomy on the ulnar artery to relieve pain.
2. A provider performs a sympathectomy on the ulnar artery to increase blood flow in a patient with compromised circulation.
3. A patient with chronic pain in the hand and forearm undergoes a sympathectomy on the ulnar artery for pain relief.
4. A provider performs a sympathectomy on the ulnar artery to improve blood flow in a patient with ulnar artery stenosis.
5. A patient with Raynaud’s disease undergoes a sympathectomy on the ulnar artery to alleviate symptoms.