How To Use CPT Code 64866

CPT 64866 describes the surgical procedure of anastomosis between the facial nerve and the spinal accessory nerve. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64866?

CPT 64866 can be used to describe the surgical connection or joining of the facial nerve and the spinal accessory nerve. This procedure is performed to restore facial motor function in patients who have experienced facial nerve loss due to a tumor or injury resulting in paralysis.

2. Official Description

The official description of CPT code 64866 is: ‘Anastomosis; facial-spinal accessory.’

3. Procedure

1. The provider begins by making an incision on the side of the neck to access the facial and spinal accessory nerves.
2. Using high-power magnification, the provider carefully trims back the outermost layer of the spinal accessory nerve, taking care not to damage surrounding structures.
3. The same process is repeated for the facial nerve, exposing the fine nerve filaments of both nerves.
4. The provider sutures the spinal accessory nerve to the facial nerve without creating tension, allowing for nerve repair.
5. Finally, the incision or wound is closed.

4. Qualifying circumstances

CPT 64866 is performed when there is a need to restore facial motor function in patients who have experienced facial nerve loss. This loss can be due to a tumor or injury that causes paralysis. The procedure involves the surgical connection or joining of the facial nerve and the spinal accessory nerve.

5. When to use CPT code 64866

CPT code 64866 should be used when the provider performs the surgical anastomosis between the facial nerve and the spinal accessory nerve to restore facial motor function. It is important to note that this code should not be used for any other procedures or circumstances.

6. Documentation requirements

To support a claim for CPT 64866, the provider must document the following information:

• Patient’s diagnosis and the need for facial motor function restoration
• Details of the surgical procedure, including the incision, trimming of nerves, and suturing
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 64866, ensure that the procedure meets the criteria for facial-spinal accessory anastomosis. It is important to follow the specific guidelines and documentation requirements for accurate billing. CPT code 64866 should not be reported with other codes unless additional procedures were performed during the same session.

8. Historical information

CPT 64866 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone changes, including being added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes facial-spinal accessory anastomosis to restore facial motor function after facial nerve loss caused by a tumor.
2. An individual experiences facial nerve paralysis due to an injury and requires surgical connection between the facial nerve and the spinal accessory nerve.
3. A provider performs anastomosis between the facial nerve and the spinal accessory nerve to restore facial motor function in a patient with facial nerve loss.
4. Facial-spinal accessory anastomosis is performed on a patient who has suffered facial nerve paralysis as a result of a tumor.
5. A surgical procedure is conducted to join the facial nerve and the spinal accessory nerve, restoring facial motor function in a patient with facial nerve loss.
6. An individual undergoes facial-spinal accessory anastomosis to regain facial motor function after experiencing facial nerve paralysis due to an injury.
7. A provider performs anastomosis between the facial nerve and the spinal accessory nerve to restore facial motor function in a patient with facial nerve loss caused by a tumor.
8. Facial-spinal accessory anastomosis is performed on a patient who has suffered facial nerve paralysis as a result of an injury.
9. A surgical procedure is conducted to join the facial nerve and the spinal accessory nerve, restoring facial motor function in a patient with facial nerve loss.
10. An individual undergoes facial-spinal accessory anastomosis to regain facial motor function after experiencing facial nerve paralysis due to a tumor.