How To Use CPT Code 64857

CPT 64857 describes the procedure of suturing 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 64857?

CPT 64857 can be used to describe the suturing of a major peripheral nerve in the arm or leg, other than the sciatic nerve. This code is used when a healthcare provider repairs a damaged nerve by suturing its ends together.

2. Official Description

The official description of CPT code 64857 is: ‘Suture of major peripheral nerve, arm or leg, except sciatic; without transposition.’

3. Procedure

1. The healthcare provider locates the damaged major nerve in the arm or leg, such as the radial, median, ulnar, or femoral nerve.
2. After preparing the patient and the surgical site, the provider makes an incision or works within an open wound to access the damaged nerve.
3. The provider cleans the edges of the damaged nerve ends to prepare them for repair.
4. Using sutures, the provider aligns the nerve endings and connects them together.
5. Depending on the size of the nerve, the provider may place additional sutures through the outer connective tissue around the nerve, known as the epineurium.
6. Finally, the provider closes the wound.

4. Qualifying circumstances

CPT 64857 is used when a major peripheral nerve in the arm or leg, other than the sciatic nerve, requires suturing. This procedure is typically performed when the nerve is damaged and needs to be repaired. The specific nerves treated may include the radial, median, ulnar, or femoral nerve.

5. When to use CPT code 64857

CPT code 64857 should be used when a healthcare provider performs the suturing procedure on a major peripheral nerve in the arm or leg, excluding the sciatic nerve. It is important to note that if the provider performs transposition along with the suturing, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 64857, the healthcare provider must document the following information:

• The specific major peripheral nerve that was sutured
• Details of the procedure, including any additional sutures placed through the epineurium
• Date of the procedure
• Any relevant findings or complications
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 64857, ensure that the procedure involves suturing a major peripheral nerve in the arm or leg, excluding the sciatic nerve. It is important to note that if the provider performs transposition along with the suturing, a different CPT code should be used. Additionally, consider any specific guidelines provided by the payer regarding the use of this code.

8. Historical information

CPT 64857 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 surgeon suturing the radial nerve in the arm of a patient who suffered a laceration.
2. An orthopedic specialist suturing the femoral nerve in the leg of a patient following a traumatic injury.
3. A neurosurgeon suturing the ulnar nerve in the arm of a patient with nerve damage.
4. A plastic surgeon suturing the median nerve in the hand of a patient who underwent a complex hand reconstruction procedure.
5. An orthopedic surgeon suturing the peroneal nerve in the leg of a patient with nerve entrapment.
6. A neurologist suturing the tibial nerve in the leg of a patient with nerve compression.
7. An orthopedic specialist suturing the brachial plexus nerves in the arm of a patient with a severe brachial plexus injury.
8. A plastic surgeon suturing the sciatic nerve in the leg of a patient who underwent a tumor resection.
9. A neurosurgeon suturing the sural nerve in the leg of a patient with nerve damage caused by trauma.
10. An orthopedic specialist suturing the peroneal nerve in the leg of a patient with nerve entrapment.