How To Use CPT Code 64902

CPT 64902 describes the procedure of nerve grafting using multiple strands (cable) to repair or bridge an injured portion of a subsequent nerve. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 64902?

CPT 64902 can be used to describe the additional nerve grafting procedure performed by a provider to repair or bridge a subsequent damaged nerve. This code specifically refers to the use of multiple strands (cable) in the grafting process.

2. Official Description

The official description of CPT code 64902 is: ‘Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure)’. This code should be used in conjunction with primary procedure codes 64885, 64886, 64895-64898.

3. Procedure

1. In this procedure, the provider obtains a multiple strand nerve graft to repair or bridge the subsequent damaged nerve.
2. The provider may use a section of the already harvested nerve from the initial procedure or acquire the appropriate length in the same manner as the first.
3. If necessary, the provider makes an incision over the nerve being harvested, locates the nerve, and cuts the desired length of nerve segment for the graft.
4. The provider then closes the donor site by suturing the skin layers together.
5. Next, the provider accesses the site of the subsequent damaged nerve.
6. If the subsequent graft is performed at the same location as the initial site, the provider accesses the nerve through the initial incision or wound.
7. If the subsequent damaged nerve is at a different location, the provider makes an incision over that site.
8. In either case, the provider locates the damaged nerve, resects and removes the damaged portion, and repairs it using a microsurgical technique.
9. The provider rejoins the individual nerve bundles within the nerve and sutures the proximal and distal ends together using the multiple strand donor nerve graft.
10. Finally, the provider closes the wound by suturing the skin layers together.

4. Qualifying circumstances

CPT 64902 is used when the provider performs an additional nerve grafting procedure using multiple strands (cable) to repair or bridge a subsequent damaged nerve. This procedure is typically performed during the same session as the initial nerve grafting procedure.

5. When to use CPT code 64902

CPT code 64902 should be used when the provider performs an additional nerve grafting procedure using multiple strands (cable) to repair or bridge a subsequent damaged nerve. This code should be reported in addition to the primary procedure code for the initial nerve grafting procedure.

6. Documentation requirements

To support a claim for CPT 64902, the provider must document the following information:

• Details of the primary procedure for which the additional nerve grafting procedure is being performed
• Description of the subsequent damaged nerve and the need for repair or bridging
• Method of obtaining the multiple strand nerve graft
• Location and length of the nerve segment used for the graft
• Details of the microsurgical technique used to repair the damaged nerve
• Documentation of the closure of the donor site and the wound

7. Billing guidelines

When billing for CPT 64902, ensure that the provider performs an additional nerve grafting procedure using multiple strands (cable) to repair or bridge a subsequent damaged nerve. This code should be listed separately in addition to the primary procedure code for the initial nerve grafting procedure. Modifier 51 or modifier 59 is not necessary with add-on codes like CPT 64902.

8. Historical information

CPT 64902 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 an additional nerve grafting procedure using multiple strands to repair a subsequent damaged nerve in the hand.
2. A neurologist performs an additional nerve grafting procedure using multiple strands to bridge a subsequent damaged nerve in the leg.
3. An orthopedic surgeon performs an additional nerve grafting procedure using multiple strands to repair a subsequent damaged nerve in the shoulder.
4. A plastic surgeon performs an additional nerve grafting procedure using multiple strands to bridge a subsequent damaged nerve in the face.
5. A hand surgeon performs an additional nerve grafting procedure using multiple strands to repair a subsequent damaged nerve in the wrist.
6. A neurosurgeon performs an additional nerve grafting procedure using multiple strands to bridge a subsequent damaged nerve in the spine.
7. An oral and maxillofacial surgeon performs an additional nerve grafting procedure using multiple strands to repair a subsequent damaged nerve in the jaw.
8. A vascular surgeon performs an additional nerve grafting procedure using multiple strands to bridge a subsequent damaged nerve in the leg.
9. An otolaryngologist performs an additional nerve grafting procedure using multiple strands to repair a subsequent damaged nerve in the neck.
10. A plastic surgeon performs an additional nerve grafting procedure using multiple strands to bridge a subsequent damaged nerve in the breast.