How To Use CPT Code 64856

CPT 64856 describes the procedure of suturing and transposing a major peripheral nerve in the arm or leg, excluding the sciatic nerve. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64856?

CPT 64856 can be used to describe the repair of a major peripheral nerve in the arm or leg, excluding the sciatic nerve. During this procedure, the physician sutures the damaged nerve and may also transpose it to a more suitable location nearby.

2. Official Description

The official description of CPT code 64856 is: ‘Suture of major peripheral nerve, arm or leg, except sciatic; including transposition.’

3. Procedure

1. The physician begins by making an incision or working in an open wound to locate the damaged major nerve in the arm or leg.
2. Once the nerve is identified, the physician cleans the edges of the damaged nerve ends to prepare them for repair.
3. The physician aligns the nerve endings and sutures them together using sutures placed through the outer connective tissue around the nerve (epineurium).
4. Additional sutures may be placed depending on the size of the nerve.
5. If necessary, the physician transposes the nerve, moving it to a more suitable area nearby.
6. Finally, the physician closes the wound.

4. Qualifying circumstances

CPT 64856 is used for patients who require the repair of a major peripheral nerve in the arm or leg, excluding the sciatic nerve. The procedure is typically performed on nerves such as the radial, median, ulnar, or femoral. The physician must suture the nerve and may also transpose it to a more suitable location nearby.

5. When to use CPT code 64856

CPT code 64856 should be used when a physician performs the suturing and transposition of a major peripheral nerve in the arm or leg, excluding the sciatic nerve. It is important to note that if the physician does not perform transposition, a different code should be used.

6. Documentation requirements

To support a claim for CPT 64856, the physician must document the following information:

• Patient’s diagnosis and the need for nerve repair
• Details of the procedure, including the specific nerve repaired and whether transposition was performed
• Date of the procedure
• Any additional information relevant to the case
• Signature of the physician performing the procedure

7. Billing guidelines

When billing for CPT 64856, ensure that the procedure involves the suturing and transposition of a major peripheral nerve in the arm or leg, excluding the sciatic nerve. It is important to follow the specific guidelines for reporting this code and to consider any additional codes that may be necessary based on the procedure performed.

8. Historical information

CPT 64856 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 physician suturing and transposing the ulnar nerve in the arm of a patient with nerve damage.
2. A surgeon repairing the radial nerve in the leg of a patient who experienced trauma.
3. A neurologist suturing and transposing the median nerve in the arm of a patient with carpal tunnel syndrome.
4. An orthopedic surgeon repairing the femoral nerve in the leg of a patient with nerve compression.
5. A plastic surgeon suturing and transposing a major peripheral nerve in the arm of a patient undergoing reconstructive surgery.
6. A neurosurgeon repairing the ulnar nerve in the leg of a patient with nerve entrapment.
7. An orthopedic surgeon suturing and transposing the radial nerve in the arm of a patient with nerve injury.
8. A hand surgeon repairing the median nerve in the leg of a patient with nerve laceration.
9. A neurologist suturing and transposing a major peripheral nerve in the arm of a patient with nerve dysfunction.
10. An orthopedic surgeon repairing the femoral nerve in the leg of a patient with nerve degeneration.