How To Use CPT Code 64901

CPT 64901 describes the additional nerve graft procedure performed by a provider to bridge or repair a subsequent nerve using a single strand of unrelated 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 64901?

CPT 64901 can be used to describe the additional nerve graft procedure performed by a provider to bridge or repair a subsequent nerve using a single strand of unrelated nerve. This code is used when the provider harvests a section of nerve from the initial procedure or acquires the appropriate length to use as a graft for the subsequent damaged nerve. The graft is typically a portion of a sensory nerve.

2. Official Description

The official description of CPT code 64901 is: ‘Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure)’. This code should be used in conjunction with the primary procedure codes 64885-64893.

3. Procedure

1. The provider obtains a single strand nerve graft either from the already harvested nerve from the initial procedure or acquires the appropriate length from another source.
2. If necessary, the provider makes an incision over the nerve he is harvesting, locates the nerve, and cuts the desired length of nerve segment for the graft.
3. The provider then closes the donor site by suturing the skin layers together.
4. The provider accesses the site of the subsequent damaged nerve either through the initial incision or by making a new incision over the site.
5. The provider locates and resects the damaged portion of the nerve.
6. The provider sutures the single strand donor nerve graft to the end of the transected nerve, ensuring enough soft tissue surrounds the graft to protect it from external trauma.
7. The provider checks for any obstruction or compression of the graft to ensure proper innervation.
8. The provider closes the wound by suturing the skin layers together.

4. Qualifying circumstances

Patients eligible for CPT 64901 are those who require an additional nerve graft procedure to bridge or repair a subsequent nerve. This code is used when the provider uses a single strand of unrelated nerve for the graft. The procedure is typically performed at the same session as the initial bridge or repair of an initial nerve.

5. When to use CPT code 64901

CPT code 64901 should be used when the provider performs an additional nerve graft procedure using a single strand of unrelated nerve to bridge or repair a subsequent nerve. This code should be used in addition to the primary procedure code for the initial nerve graft.

6. Documentation requirements

To support a claim for CPT 64901, the provider must document the following information:

• Explanation of the need for the additional nerve graft procedure
• Description of the single strand nerve graft used
• Date of the procedure
• Details of the procedure, including the location of the harvested nerve, the location of the subsequent damaged nerve, and the steps taken to perform the graft
• Confirmation of proper innervation and absence of obstruction or compression of the graft
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 64901, ensure that the procedure meets the criteria for an additional nerve graft using a single strand of unrelated nerve. This code should be reported in addition to the primary procedure code for the initial nerve graft. Modifier 51 or modifier 59 is not necessary with add-on codes. If the procedure is performed bilaterally, report the add-on code twice without appending modifier 50.

8. Historical information

CPT 64901 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 provider performs an additional nerve graft procedure using a single strand of unrelated nerve to bridge or repair a subsequent nerve in a patient who had previously undergone a nerve graft for a different nerve.
2. A surgeon harvests a section of nerve from the initial procedure and uses it as a graft to repair a subsequent damaged nerve in the same patient.
3. A provider acquires an appropriate length of unrelated nerve to use as a graft for the subsequent damaged nerve in a patient who had previously undergone a nerve graft procedure.
4. A surgeon performs an additional nerve graft procedure using a single strand of unrelated nerve to bridge or repair a subsequent nerve in a patient who had previously undergone a nerve repair procedure.
5. A provider uses a portion of a sensory nerve as a single strand graft to repair a subsequent damaged nerve in a patient who had previously undergone a nerve graft procedure.
6. A surgeon performs an additional nerve graft procedure using a single strand of unrelated nerve to bridge or repair a subsequent nerve in a patient who had previously undergone a nerve reconstruction procedure.
7. A provider harvests a section of nerve from the initial procedure and uses it as a graft to repair a subsequent damaged nerve in a patient who had previously undergone a nerve reconstruction procedure.
8. A surgeon acquires an appropriate length of unrelated nerve to use as a graft for the subsequent damaged nerve in a patient who had previously undergone a nerve reconstruction procedure.
9. A provider performs an additional nerve graft procedure using a single strand of unrelated nerve to bridge or repair a subsequent nerve in a patient who had previously undergone a nerve transfer procedure.
10. A surgeon uses a portion of a sensory nerve as a single strand graft to repair a subsequent damaged nerve in a patient who had previously undergone a nerve transfer procedure.