How To Use CPT Code 64872

CPT 64872 describes the procedure for suture of a nerve that requires secondary or delayed repair. 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 64872?

CPT 64872 can be used to describe the procedure of suturing a nerve that requires secondary or delayed repair. This code is used when the initial repair of the nerve is delayed due to circumstances or medical necessity. The secondary or delayed repair may be intentional, such as in cases of contaminated or infected wounds, severe traction or crushing injuries, or delayed presentation of the injury. The procedure aims to restore sensory and/or motor functions by repairing the damaged or severed nerves.

2. Official Description

The official description of CPT code 64872 is: ‘Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy).’ This code should be used in conjunction with the primary code for primary neurorrhaphy.

3. Procedure

1. The provider prepares the patient and accesses the injured nerve through an open wound or incision.
2. The damaged ends of the nerve, including scar tissue, are trimmed back to expose healthy nerve fibers.
3. The provider uses high-power magnification to carefully dissect the area, taking care not to injure surrounding structures.
4. The healthy nerve ends are sutured together without creating tension.
5. If the damaged nerve has both motor and sensory functions, a group of nerve fibers may be gathered and sutured together.
6. The wound or incision is closed.

4. Qualifying circumstances

CPT 64872 is used when the repair of a nerve is delayed due to circumstances or medical necessity. This may include contaminated or infected wounds, severe traction or crushing injuries, delayed presentation of the injury, or a prolonged interval between the injury and the patient seeking care. The procedure aims to restore sensory and/or motor functions when the nerves become damaged or severed usually as a result of injury or trauma.

5. When to use CPT code 64872

CPT code 64872 should be used when a secondary or delayed repair of a nerve is necessary. It is important to use this code in addition to the primary code for primary neurorrhaphy. This code should not be reported without an appropriate primary code.

6. Documentation requirements

To support a claim for CPT 64872, the provider must document the following information:

• Reason for the delayed repair of the nerve
• Details of the procedure, including the specific nerve repaired and any additional procedures performed
• Date of the procedure
• Start and end time of the procedure
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64872, ensure that the procedure meets the criteria for a secondary or delayed repair of a nerve. This code should be used in addition to the primary code for primary neurorrhaphy. Payers may not reimburse if CPT 64872 is reported without an appropriate primary code. It is important to follow the specific guidelines provided by the payer for accurate billing.

8. Historical information

CPT 64872 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 patient presents with a contaminated wound that requires delayed repair of a severed nerve. The provider performs the procedure to suture the nerve, restoring sensory and motor functions.
2. Due to a severe traction injury, a patient requires secondary repair of a damaged nerve. The provider performs the procedure to suture the nerve, aiming to restore sensory and motor functions.
3. A patient seeks care weeks after sustaining a nerve injury. The provider performs the delayed repair of the nerve, suturing the healthy nerve ends together to restore sensory and motor functions.
4. Following a prolonged interval between injury and seeking care, a patient requires secondary repair of a severed nerve. The provider performs the procedure to suture the nerve, aiming to restore sensory and motor functions.
5. A contaminated wound results in a delayed repair of a damaged nerve. The provider performs the procedure to suture the nerve, restoring sensory and motor functions.
6. Due to a severe crushing injury, a patient requires secondary repair of a severed nerve. The provider performs the procedure to suture the nerve, aiming to restore sensory and motor functions.
7. A patient presents with a delayed presentation of a nerve injury. The provider performs the delayed repair of the nerve, suturing the healthy nerve ends together to restore sensory and motor functions.
8. Following a prolonged interval between injury and seeking care, a patient requires secondary repair of a damaged nerve. The provider performs the procedure to suture the nerve, aiming to restore sensory and motor functions.
9. A contaminated wound results in a delayed repair of a severed nerve. The provider performs the procedure to suture the nerve, restoring sensory and motor functions.
10. Due to a severe traction injury, a patient requires secondary repair of a damaged nerve. The provider performs the procedure to suture the nerve, aiming to restore sensory and motor functions.