How To Use CPT Code 64874

CPT 64874 describes the procedure of suture of a nerve that requires extensive mobilization or transposition of the 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 64874?

CPT 64874 can be used to describe the repair of a portion of a nerve that is too short and cannot be reconnected without tension. The procedure involves freeing the nerve from the nerve bed or repositioning the nerve in the bed. This restores sensory and/or motor functions when the nerves become damaged or severed due to injury or trauma.

2. Official Description

The official description of CPT code 64874 is: ‘Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture)’. This code should be used in conjunction with the primary code for nerve suture.

3. Procedure

1. During the procedure, the healthcare provider assesses the nerve and determines the need for extensive mobilization or transposition.
2. If the nerve is too short to be reconnected without tension, the provider frees the nerve ends from surrounding structures to release the nerve and allow for a tension-free repair.
3. If mobilization alone is not enough to relieve tension when the nerve ends connect, the provider may remove the nerve from adjacent tissues and reposition it to shorten the distance between the severed ends.
4. The provider takes care to avoid excessive stripping of small vessels to the nerve, especially protecting motor and essential sensory branches.
5. Once the nerve is mobilized or transposed, the provider completes the nerve repair.

4. Qualifying circumstances

CPT 64874 is used when the repair of a nerve requires extensive mobilization or transposition. This procedure is performed when there is a small nerve gap or segmental defect that cannot be overcome without freeing the nerve ends from surrounding structures or repositioning the nerve. The provider must ensure that the nerve repair is necessary to restore sensory and/or motor functions.

5. When to use CPT code 64874

CPT code 64874 should be used when the repair of a nerve requires extensive mobilization or transposition. It is important to use this code in addition to the primary code for nerve suture to accurately represent the additional work needed for the repair.

6. Documentation requirements

To support a claim for CPT 64874, the healthcare provider must document the following information:

• The need for extensive mobilization or transposition of the nerve
• The specific nerve suture procedure performed
• The date and duration of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 64874, ensure that the procedure involves extensive mobilization or transposition of the nerve. This code should be reported in addition to the primary code for nerve suture. Payers may not reimburse for CPT 64874 if it is reported without an appropriate primary code. It is important to follow the specific guidelines provided by the payer for accurate billing and reimbursement.

8. Historical information

CPT 64874 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 performs a suture of a nerve requiring extensive mobilization to repair a segmental defect in a patient’s radial nerve.
2. A neurologist performs a suture of a nerve requiring transposition to repair a segmental defect in a patient’s ulnar nerve.
3. An orthopedic surgeon performs a suture of a nerve requiring extensive mobilization to repair a segmental defect in a patient’s peroneal nerve.
4. A plastic surgeon performs a suture of a nerve requiring transposition to repair a segmental defect in a patient’s facial nerve.
5. A hand surgeon performs a suture of a nerve requiring extensive mobilization to repair a segmental defect in a patient’s median nerve.
6. A neurosurgeon performs a suture of a nerve requiring transposition to repair a segmental defect in a patient’s sciatic nerve.
7. An otolaryngologist performs a suture of a nerve requiring extensive mobilization to repair a segmental defect in a patient’s glossopharyngeal nerve.
8. A vascular surgeon performs a suture of a nerve requiring transposition to repair a segmental defect in a patient’s brachial plexus.
9. A plastic surgeon performs a suture of a nerve requiring extensive mobilization to repair a segmental defect in a patient’s facial nerve.
10. An orthopedic surgeon performs a suture of a nerve requiring transposition to repair a segmental defect in a patient’s ulnar nerve.