How To Use CPT Code 64859

CPT 64859 describes the procedure for suture of each additional major peripheral nerve, which is an add-on code used in conjunction with primary procedures. 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 64859?

CPT 64859 is a code used to describe the repair of additional peripheral nerves that may be damaged due to trauma, lesions, infection, or other conditions. This code is an add-on code, meaning it is used in conjunction with primary procedures. It is important to note that CPT 64859 should be reported separately for each additional major peripheral nerve that requires suturing.

2. Official Description

The official description of CPT code 64859 is: ‘Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure).’ This code should be used in conjunction with primary procedures, such as nerve repair or reconstruction.

3. Procedure

1. After appropriate patient preparation and anesthesia, the healthcare provider makes an incision or works through an open wound to access the damaged peripheral nerve.
2. The provider locates the peripheral nerve and identifies the area of damage.
3. The edges of the damaged nerve ends are cleaned to prepare them for repair.
4. The provider aligns the nerve endings and places sutures through the epineurium, the outer connective tissue around the nerve, to connect the nerve endings.
5. Additional sutures may be placed depending on the size of the nerve.
6. The provider ensures that the nerve(s) are properly joined together to restore proper function.
7. If necessary, the provider may also reconstruct the nerve before suturing the area closed.

4. Qualifying circumstances

CPT 64859 is used when there is a need to repair additional major peripheral nerves in addition to the primary procedure. The damage to the peripheral nerves may be caused by trauma, lesions, infection, or other conditions. It is important to note that this code should only be used for major peripheral nerves and not for minor nerves.

5. When to use CPT code 64859

CPT code 64859 should be used when there is a need to suture each additional major peripheral nerve in conjunction with a primary procedure. It is important to report this code separately for each additional major peripheral nerve that requires suturing.

6. Documentation requirements

To support a claim for CPT 64859, the healthcare provider must document the following information:

• Identification of the primary procedure performed
• Number of additional major peripheral nerves sutured
• Details of the procedure, including the location and extent of the damage
• Specifics of the suturing technique used
• Any additional reconstruction or closure performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 64859, it is important to ensure that the primary procedure is also reported. This code should be used in conjunction with the primary procedure code. It is important to report CPT 64859 separately for each additional major peripheral nerve that requires suturing. It should not be reported if the primary procedure does not involve the repair of major peripheral nerves.

8. Historical information

CPT 64859 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a primary procedure for the repair of a major peripheral nerve in the arm. During the same surgery, the healthcare provider identifies and repairs an additional major peripheral nerve in the same arm using sutures. CPT code 64859 should be reported separately for the repair of the additional major peripheral nerve.
2. A patient undergoes a primary procedure for the reconstruction of a major peripheral nerve in the leg. During the same surgery, the healthcare provider identifies and repairs two additional major peripheral nerves in the same leg using sutures. CPT code 64859 should be reported twice, separately for each additional major peripheral nerve that requires suturing.
3. A patient undergoes a primary procedure for the repair of a major peripheral nerve in the hand. During the same surgery, the healthcare provider identifies and repairs three additional major peripheral nerves in the same hand using sutures. CPT code 64859 should be reported three times, separately for each additional major peripheral nerve that requires suturing.
4. A patient undergoes a primary procedure for the reconstruction of a major peripheral nerve in the face. During the same surgery, the healthcare provider identifies and repairs four additional major peripheral nerves in the same face using sutures. CPT code 64859 should be reported four times, separately for each additional major peripheral nerve that requires suturing.
5. A patient undergoes a primary procedure for the repair of a major peripheral nerve in the neck. During the same surgery, the healthcare provider identifies and repairs multiple minor peripheral nerves in the same neck using sutures. CPT code 64859 should not be reported for the repair of minor peripheral nerves.