How To Use CPT Code 64910

CPT 64910 describes the procedure of nerve repair using a synthetic conduit or vein allograft. 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 64910?

CPT 64910 can be used to describe the procedure of nerve repair using a synthetic conduit or vein allograft. This code is used when a provider fills a nerve gap and repairs a nerve by using an artificial tube or passageway or a vein from a living or cadaveric source.

2. Official Description

The official description of CPT code 64910 is: ‘Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve.’

3. Procedure

1. The provider makes an incision over the site where the damaged nerve is present.
2. He continues to dissect until he exposes the nerve.
3. Using loupe magnification or an operating microscope, he locates the damaged portion of the nerve and resects and removes the damaged section as necessary.
4. The provider measures the gap between the nerve ends and then measures the diameter of the nerve.
5. He selects an appropriately sized synthetic conduit or vein allograft and places it in the gap between the nerve endings.
6. Using microsurgical techniques, he repairs the nerve by suturing the proximal and distal ends of the nerve inside the conduit.
7. Finally, he closes the wound by suturing the skin layers together.

4. Qualifying circumstances

Patients who require nerve repair using a synthetic conduit or vein allograft are eligible for CPT 64910. The procedure is performed when there is a nerve gap that needs to be filled and repaired. The provider uses an artificial tube or vein from a living or cadaveric source to bridge the gap and facilitate nerve regeneration.

5. When to use CPT code 64910

CPT code 64910 should be used when a provider performs nerve repair using a synthetic conduit or vein allograft. It is important to accurately document the procedure and ensure that the distinct procedural service rules are met for a separate procedure and separate site.

6. Documentation requirements

To support a claim for CPT 64910, the provider must document the following information:

• Patient’s diagnosis and the need for nerve repair
• Details of the synthetic conduit or vein allograft used
• Measurement of the nerve gap and diameter
• Techniques used for nerve repair
• Details of the closure of the wound

7. Billing guidelines

When billing for CPT 64910, ensure that the procedure involves the use of a synthetic conduit or vein allograft. It is important to follow the guidelines for reporting multiple nerves and to append modifier 59 to indicate a separate procedure and separate site. It is also important to use the appropriate codes for autogenous vein graft repair if applicable.

8. Historical information

CPT 64910 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Examples

1. A provider performs nerve repair using a synthetic conduit to bridge a gap in the ulnar nerve.
2. Using a vein allograft, a provider repairs a damaged radial nerve in a patient.
3. A surgeon uses a synthetic conduit to repair a damaged median nerve in a carpal tunnel release procedure.
4. During a nerve repair procedure, a provider uses a vein allograft to bridge a gap in the sciatic nerve.
5. A patient undergoes nerve repair using a synthetic conduit to repair a damaged peroneal nerve.
6. A provider performs nerve repair using a vein allograft to bridge a gap in the facial nerve.
7. Using a synthetic conduit, a surgeon repairs a damaged femoral nerve in a patient.
8. A provider uses a vein allograft to repair a damaged tibial nerve in a patient.
9. During a nerve repair procedure, a surgeon uses a synthetic conduit to bridge a gap in the brachial plexus.
10. A patient undergoes nerve repair using a vein allograft to repair a damaged phrenic nerve.