How To Use CPT Code 64823

CPT 64823 describes a procedure known as sympathectomy, specifically targeting the superficial palmar arch of the hand. 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 64823?

CPT 64823 is a code used to describe a surgical procedure called sympathectomy. This procedure focuses on the superficial palmar arch of the hand, aiming to relieve pain or improve blood flow in patients with narrowed blood vessels.

2. Official Description

The official description of CPT code 64823 is: ‘Sympathectomy; superficial palmar arch.’ It is important to note that code 69990 should not be reported in addition to code 64823.

3. Procedure

1. During the procedure, the healthcare provider prepares the patient and administers anesthesia.
2. An incision is made directly over the superficial palmar arch, exposing the underlying muscle, fat, and fibrous tissue.
3. The provider carefully identifies and locates the superficial palmar arch.
4. Using loupe magnification, the provider removes or excises the adventitial tissue, which covers the arch and contains the sympathetic nerves.
5. The procedure requires meticulous dissection to avoid injury to surrounding structures.
6. After completing the dissection, the wound is irrigated, and the incised tissue and skin are closed.

4. Qualifying circumstances

CPT 64823 is performed on patients who experience pain or have narrowed blood vessels that can benefit from sympathectomy of the superficial palmar arch. The procedure is typically carried out by a healthcare provider who is skilled in this specific surgical technique.

5. When to use CPT code 64823

CPT code 64823 should be used when a sympathectomy is performed on the superficial palmar arch. It is important to note that this code should not be used in conjunction with code 69990.

6. Documentation requirements

To support a claim for CPT 64823, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for sympathectomy
• Details of the procedure, including the incision site and the use of loupe magnification
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 64823, ensure that the procedure performed is sympathectomy of the superficial palmar arch. Code 69990 should not be reported in addition to code 64823. It is important to follow the specific guidelines provided by the payer and accurately document the procedure to support the claim.

8. Historical information

CPT 64823 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with Raynaud’s disease undergoes sympathectomy of the superficial palmar arch to alleviate symptoms and improve blood flow in the hand.
2. A surgeon performs sympathectomy of the superficial palmar arch on a patient with chronic hand pain caused by narrowed blood vessels.
3. A patient with vascular insufficiency in the hand undergoes sympathectomy of the superficial palmar arch to enhance blood flow and promote healing.
4. A healthcare provider performs sympathectomy of the superficial palmar arch on a patient with complex regional pain syndrome to alleviate symptoms and improve function.
5. A patient with hand ischemia undergoes sympathectomy of the superficial palmar arch to restore blood flow and prevent tissue damage.
6. A surgeon performs sympathectomy of the superficial palmar arch on a patient with vasospastic disorders to reduce episodes of vasoconstriction and associated pain.
7. A patient with digital ulcers caused by systemic sclerosis undergoes sympathectomy of the superficial palmar arch to promote healing and prevent further ulceration.
8. A healthcare provider performs sympathectomy of the superficial palmar arch on a patient with reflex sympathetic dystrophy to alleviate pain and improve function.
9. A patient with hand tremors undergoes sympathectomy of the superficial palmar arch to reduce sympathetic nerve activity and control the tremors.
10. A surgeon performs sympathectomy of the superficial palmar arch on a patient with hyperhidrosis to reduce excessive sweating in the hand.