How To Use CPT Code 64905

CPT 64905 describes the procedure of nerve pedicle transfer, specifically the first stage. 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 64905?

CPT 64905 is used to describe a specific surgical procedure known as nerve pedicle transfer. This procedure involves transferring a portion of a healthy, less important donor nerve to a damaged recipient nerve. The purpose of this transfer is to help the damaged nerve reconnect faster and recover its function more quickly. Nerve pedicle transfer is typically performed in complex cases, such as brachial plexus injuries or when a nerve root has been torn from the spinal cord.

2. Official Description

The official description of CPT code 64905 is: ‘Nerve pedicle transfer; first stage.’

3. Procedure

1. In the first stage of the nerve pedicle transfer procedure, the surgeon begins by preparing the patient and administering anesthesia.
2. The surgeon then makes an incision over the location of the donor nerve and carefully dissects to expose the nerve.
3. Using magnification tools such as loupe magnification or an operating microscope, the surgeon locates and frees the donor nerve.
4. A portion of the donor nerve is excised and prepared for transfer to the damaged recipient nerve.
5. The surgeon then uses microsurgical techniques to join the cut end of the healthy donor nerve to the damaged recipient nerve.
6. For example, the ulnar nerve, which innervates the lower arm, may be used to repair a torn nerve of the brachial plexus, helping to restore elbow function, shoulder abduction, or the hands’ ability to hold or grasp.
7. Finally, the surgeon closes the wound by suturing the layers of skin together.

4. Qualifying circumstances

CPT 64905 is typically performed in cases where there is a need to repair a damaged nerve using a nerve pedicle transfer. This procedure is often necessary when a patient has a complex injury, such as a brachial plexus injury, or when a nerve root has been torn from the spinal cord. The surgeon must determine that a nerve pedicle transfer is the most appropriate course of action to help the damaged nerve reconnect and regain its function.

5. When to use CPT code 64905

CPT code 64905 should be used when a surgeon performs the first stage of a nerve pedicle transfer procedure. This code specifically applies to the initial part of the procedure, where a portion of a healthy donor nerve is transferred to a damaged recipient nerve. It is important to note that CPT code 64905 should not be used for subsequent stages of the nerve pedicle transfer procedure.

6. Documentation requirements

To support a claim for CPT code 64905, the surgeon must document the following information:

• Patient’s diagnosis and the need for a nerve pedicle transfer
• Details of the procedure, including the location of the donor nerve and the damaged recipient nerve
• Date of the procedure
• Specific steps taken during the procedure, such as the excision of the donor nerve and the microsurgical techniques used for nerve repair
• Any complications or additional procedures performed
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT code 64905, it is important to ensure that the procedure performed aligns with the description of the code. The surgeon should only report CPT code 64905 for the first stage of a nerve pedicle transfer procedure. If subsequent stages are performed, different codes should be used. It is also important to follow any specific billing guidelines provided by the payer or insurance company.

8. Historical information

CPT code 64905 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A surgeon performs the first stage of a nerve pedicle transfer procedure, using a portion of the ulnar nerve to repair a torn nerve of the brachial plexus.
2. In a complex case, a surgeon transfers a segment of a healthy donor nerve to a damaged recipient nerve to help restore function in the patient’s hand.
3. A patient with a severe brachial plexus injury undergoes the first stage of a nerve pedicle transfer procedure to improve shoulder abduction and hand function.
4. A surgeon performs the initial part of a nerve pedicle transfer procedure, using a healthy donor nerve to repair a damaged nerve in a patient with a spinal cord injury.
5. In a complex nerve injury case, a surgeon performs the first stage of a nerve pedicle transfer procedure to help restore function in the patient’s arm and hand.
6. A patient with a brachial plexus injury undergoes the first stage of a nerve pedicle transfer procedure, with the surgeon using a portion of a healthy donor nerve to repair the damaged nerves.
7. In a complex nerve reconstruction case, a surgeon performs the initial part of a nerve pedicle transfer procedure to improve function in the patient’s hand and arm.
8. A patient with a severe nerve injury undergoes the first stage of a nerve pedicle transfer procedure, with the surgeon transferring a healthy donor nerve to repair the damaged nerve.
9. In a complex nerve repair case, a surgeon performs the initial part of a nerve pedicle transfer procedure to help restore function in the patient’s hand and fingers.