Cpt code for digital nerve repair finger CPT1 Code CPT Code Description RVUsB 20222 Payment Neuroplasty Coding Examples 28035 Release, tarsal tunnel (posterior tibial nerve decompression) 10. The surgeon, level of training, repair time, and stitches per repair were not significantly related to an excellent repair. To reflect this focus, coding guidelines for a variety of nerve procedures will be covered. Although autologous graft remains the reference standard for reconstruction At the wrist, the ulnar nerve enters the hand through the Guyon canal. My only guess is since 64726 is for Plantar digital Injury of digital nerve of other finger, subsequent encounter S64. , nerve tube), each nerve 22. 494 is based on the following Tabular structure:. Br J Plast Surg. Before this code is reported the coder should take the following steps: Library - buy digital books from Find-A-Code; CEUs & Training - sources; CPT code 64893, Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length, did not seem appropriate as the physician did not harvest the graft. Results of clinical assessment after primary digital nerve repair. nerve originates from C5-C7 while both radial and median nerves originate ICD-10 code S64. 5 Nerve repair is often prioritized as long as the Diagnosis is typically clinical with a combination of known injury with a nerve deficit. CPT Code 64897 CPT Code 64910. 5. Suture of digital nerve, hand or foot; one nerve (64831) Suture of digital nerve, hand or foot; each additional (64832) Suture of nerve; requiring secondary or delayed suture list separately in The Current Procedural Terminology (CPT ®) code 64831 as maintained by American Medical Association, is a medical procedural code under the range - Neurorrhaphy Procedures. -Starting at 3 weeks, gradually increase MP joint extension by 15 degrees weekly. Weber et al 17 performed a randomized, prospective Patient underwent nerve repair for a peripheral nerve injury, left hand, to restore innervation. I looked up repair, finger, tendon, joint stabilization. 3) Multiple neuritis syndrome (354. The ulnar nerve is a mixed motor and sensory nerve formed from the fibers of the C8-T1 nerve roots and occasionally C7 nerve Tension-free primary digital nerve repair may be unachievable in the presence of a nerve defect and require digital nerve reconstruction. The aim of a digital nerve repair is to restore functional sensibility to the digit and prevent painful neuroma formation. 26548-F4, 69990 For code 26548-F4, go to CPT index main term Repair, subterm Finger, and qualifier Volar Plate. The distribution of nerve reconstruction codes is listed in Table 4. g. M. Digital Nerve Blocks. We evaluated long-term outcomes of digital nerve reconstruction with The correct code in this situation is 26770, because payers don't consider the nerve block enough to qualify for the -with anesthesia- code. Our Surgeon performed a neurectomy of ulnar Study with Quizlet and memorize flashcards containing terms like 10021 Locate the term Fine Needle Aspiration (FNA) Biopsy in the CPT Index, and the subterm without guidance, which directs the coder to CPT codes 10004, 10021. 5) CPT Codes Repair blood vessel, direct; hand, finger (35207) Ligation, major artery eg, post-traumatic, rupture); extremity (37618) Sympathectomy, digital arteries, Read the "AMA CPT Knowledge Base" question/answer titled: "For the upper extremity, do codes 64831 and 64832 indicate repair of each digital nerve" ; - Subscription do codes 64831 and 1. 49 $525 64704 Neuroplasty, nerve of hand or foot 9. After 10 minutes she reported complete resolution of all hand Apply Nail Bed, Avulsion Codes with Care. The provider performs an excision of the neuroma using CPT code 64776. If a patient has a digital nerve laceration repaired with sutures and then they wrap it with an Axogen nerve wrap, is an additional code assigned for the Read the "AMA CPT Knowledge Base" question/answer titled: "What code(s) should be reported for common digital nerve repairs in the web spaces of" - Subscription required codes diagnosis. This guide covers scenarios and coding examples, including modifier 54 vs 84, using AI and automation for medical coding. neurolysis radial digital nerve 4th finger 3. 02 883. Enter Deck Code Active Deck patient placed in the supine position with hand on hand table leave one tail of each suture long to stabilize the nerve during the repair J. 2 Medical Coding. Conclusions: Our study indicated that microscope use produces superior quality digital nerve repair. [QxMD MEDLINE Link]. A variety of host factors influence the outcome of digital nerve repair more than the type of repair per se. Quarterly focuses on nerve injuries and repair. Toggle navigation. Repair of ulnar digital nerve left third finger. CPT Code 26770, Surgical Procedures on the Hand and Fingers, Fracture and/or Dislocation Procedures on the Hand and Fingers - Codify by AAPC Hi All, My provider did a digital nerve block for a closed manipulation of dislocated finger. 5) Neuroplasty; nerve of hand or foot (64704) Neuroplasty, major peripheral nerve, arm or leg; other than specified The Current Procedural Terminology (CPT ®) code 64708 as maintained by American Medical Association, is a medical procedural code under the range - Neuroplasty (Exploration, Neurolysis or Nerve Decompression) Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System. Code 64721 does not include nerve wrapping. CPT code 64912 should be used when a provider performs a nerve repair procedure using a nerve allograft, focusing on the first strand or cable. 2), median nerve lesions (ICD-9 code 354. 1%). 492A is a billable diagnosis code used to specify a medical diagnosis of injury of digital nerve of right middle finger, initial encounter. Chapter 19: Injury, poisoning and certain other consequences of external causes. 494A coding with all applicable Excludes 1 and Excludes 2 notes from the Radial Tunnel Codes. Lanzinger. This procedure is performed to relieve pain and restore nerve function CPT is trademark of the American Medical Association. antebrachial cut. A patient has a neuroma on the digital nerve of their ring finger, resulting in chronic pain and limited mobility. 1998; 51:637-639. Nail bed repair generally requires the use of absorbable sutures such as Vicryl, chromic, or gut utilized in a single layer repair (11760 Repair of nail bed). What is CPT Code 64832? CPT 64832 can be used A plastic surgeon performs a nerve repair procedure on a patient’s facial nerve using a nerve allograft, focusing on the first strand or cable. Scopus (135) PubMed. Excision of neuroma; cutaneous nerve, surgically identifiable (64774) Excision of neuroma; digital nerve, one or both, same digit (64776) Excision of neuroma; digital nerve, each additional digit (list separately by this number) (64778) Excision of neuroma; hand or foot, except digital nerve (64782) CPT Code 26567, Surgical Procedures on the Hand and Fingers, Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers - Codify by AA. Plast Reconstr Surg. About half of respondents (49%) who stated that they would repair the nerve with HANA would use CPT code 64910 (nerve repair with synthetic conduit or vein allograft). We were not sure if CPT code 64910, Nerve repair; with synthetic conduit or vein allograft (e troversial whether digital nerve repair is necessary. 64708 Neuroplasty, major peripheral nerve, arm or leg, open; other than specified. Early recognition and treatment will optimize outcomes, and providers should maintain a high index In particular, zone 2 flexor tendon repairs in the hand are important, as a separate CPT code is used to describe such procedures. 61) Excision of neuroma; digital nerve, one or both, same digit (64776) Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision) (64787) Late effect of crushing (nonspecific) (906. , nerve tube], each nerve). 49 $467 +64783 Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code ICD 10 code for Injury of digital nerve of unspecified finger, initial encounter. 4 Common Nerve Block Procedures and Their CPT Codes 1. Learn how to accurately code nerve repair procedures using CPT code 64912, "Nerve Repair; with nerve allograft, each nerve, first strand (cable)". You may be wondering why you can bill for a nerve block (CPT 64450 ) with a circumcision (54150) but cannot bill for lidocaine administration with laceration repair. Suture of digital nerve, hand or foot; one nerve: Digital Nerve Repair (1st) 64831: No: Suture of digital nerve, hand or foot; each I don't do much hand coding, please help. Suture of digital nerve, hand or foot; one nerve (64831) Suture of digital nerve, hand or foot; each additional (64832) Suture of one nerve, hand or foot; common sensory nerve (64834) Suture of one nerve, hand or foot; median motor thenar (64835) Suture of one nerve, hand or foot; ulnar motor (64836) CPT1 Code CPT Code Description RVUsB 20232 Payment Neuroplasty Coding Examples 28035 Release, tarsal tunnel (posterior tibial nerve decompression) 10. J Hand Surg Am. 498A Injury of digital nerve of other finger, initial encounter S74. CPT 64727 describes a procedure known as internal neurolysis, which involves the excision of scar tissue within and between nerve fibers in the protective nerve sheath. Can I assign 64450 in addition to the suture repair code? Kentucky Subscriber Answer: If the only procedure performed was the digital block, 64450 (injection, anesthetic agent; other peripheral nerve or branch) would be reported. First, CPT bundles the lidocaine administration; there is no code for local infiltration. This code is for the first strand of each nerve graft repair. If a patient has a digital nerve laceration repaired with sutures and then they wrap it with an Axogen nerve wrap, is an additional code assigned for the Digital nerve injuries are common and often require epineural repair. 3) for 2012 and 2014, which were the only years available at the time of data Understanding CPT Codes for Ulnar Nerve Surgery. Since CPT code 26548 is NOT listed, it is separately reportable. HOME CPT 64831 describes suturing of a single digital nerve in the hand or foot. Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm in length (64890) Nerve repair with synthetic conduit, each (64910) Nerve repair with autogenous vein conduit, each, including graft harvest (64911) Digital Nerve Repair !erapy Instructions Laith Al-Shihabi, MD 2-4 weeks Splint: -Fashion a short-arm dorsal blocking splint holding the wrist in neutral, MP joints of the injured !ngers in 50 degrees of "exion, and IP joints in extension. (2018) noted that outcomes following digital nerve repair are sub-optimal despite much Repair of zone II flexor digitorum profundus laceration left middle finger. Question: Our physician sutured a patient's finger and administered a digital block for pain relief. To view the Official AMA answer and 1000s more like this: Coding Index: CPT Hand Codes: ICD Hand Codes: AMA: Nerve Graft CPT Codes. 3. 0):. ICD-10-CM; DRGs CPT Knowledgebase - Dec 23, 2020 What code(s) should be reported for common digital nerve repairs in the web spaces of the hand? Per CPT Assistant, December 2013 Page: 14 Category: Frequently Asked Questions: Surgery: Nervous System Question: Does code 64721, Neuroplasty and/or transposition; median nerve at carpal tunnel, include the work of wrapping the median nerve with a nerve conduit? Answer: No. A patient is seen at our facility to undergo a microsurgical repair of the right ulnar digital nerve with 1 cm Avance allograft, and repair of the right radial digital nerve. 84 $328 ICD 10 code for Injury of digital nerve of unspecified finger, initial encounter. Currently there are no CPT procedure codes for wrapping a nerve. months from his right long finger traumatic amputation, index finger FDS, FDP repairs, and two ulnar digital nerve repair, right ring finger repair, and distal laceration nail bed. 59 $2,033. Delayed digital nerve repair with vein conduits yielded poor results. Injury digital nerve (955. For study patients, Background Recovery of sensibility after digital nerve injury is crucial for restoring normal hand function. Table 3. Left small finger ulnar digital nerve repair, zone 2. Advanced imaging such as ultrasound or MRI may be used to characterize nerve morphology after injury; however, EMG/NCS is a mainstay of evaluating both nerve injury and nerve recovery. In this intricate procedure, the surgeon matches up the nerve fibers and uses tiny stitches to sew together the outer layer of tissue that insulates and protects the nerve. ∙ Stanec, Z. J Hand Surg [Am]. -Medicare considers reduction of Injury finger vessels (903. A hand surgeon repairs a damaged digital nerve using a nerve allograft, specifically the first strand or cable. Approximate Synonyms. 58 $332 AHA Coding Clinic ® for HCPCS - 2018 Issue 1; Ask the Editor Microsurgical repair, ulnar digital nerve. Left small finger A2 Discover comprehensive information about ICD-10-PCS code 01Q44ZZ - Repair Ulnar Nerve, Percutaneous Endoscopic Approach. Nerve Procedure CPT Codes. Excision of neuroma; cutaneous nerve, surgically identifiable (64774) Excision of neuroma; digital nerve, one or both, same digit (64776) Excision of neuroma; digital nerve, each additional digit (list separately by this number) (64778) Excision of neuroma; hand or foot, except digital nerve (64782) 26055 CPT code 26055 is a Current Procedural Terminology (CPT) code for incision procedures on the hand and fingers, specifically in the tendon sheath. 490A is grouped within Diagnostic Related Group(s) (MS-DRG v 42. Place additional sutures . A patient has a neuroma on the digital nerve of their middle finger due to a previous injury. ”What is the correct ICD-10 code for Digital nerve injuries are common and often require epineural repair. Surgical exploration is confirmatory for traumatic nerve injuries. The radial digital nerve was identified in its usual anatomic position lying obliquely just proximal to the A1 pulley. I am questioning, do I add the 64450 for the nerve block? Please help. , no Digital nerve injuries are the most common surgically treated nerve injuries among all traumatic nerve injuries. Approximately half of hand surgeons use loupes in current practice, mostly at low magnification (2. However, Digital Nerve Blocks performed as stand-alone procedures and not part of a surgical package (e. When performing Neuroplasty in conjunction with wrapping a nerve, use CPT codes 64702-64727 in addition to CPT code 64999. Excisional preparation or creation of recipient site by excision of essentially intact skin (including subcutaneous tissues), scar, or other lesion prior to repair with free skin graft (list as separate The Current Procedural Terminology (CPT ®) code 64832 as maintained by American Medical Association, is a medical procedural code under the range - Neurorrhaphy Procedures. Messages 166 Location Yakima, WA Best answers 0. This article will provide an overview of CPT code 26357, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples. When to use CPT code 64782. , nerve tube), each nerve 64912 Nerve repair; with nerve allograft, each nerve, first strand (cable) 64913 Nerve repair; with nerve allograft, each additional strand (List separately in addition to code for primary procedure) Coding Index: CPT Hand Codes: ICD Hand Codes: AMA: Nerve Procedures CPT Codes. The ulnar digital nerve was identified. Codes also differ based on the site of nerve graft placement, such as the head and neck or the hand and arm. Left small finger flexor tenolysis. 8X1A Injury of other nerves at wrist and hand level of right arm, initial encounter Under CPT/HCPCS Codes Group 1: Codes the description was revised for 64416, 64446 and 64448. 40XA is grouped within Diagnostic Related Group(s) (MS-DRG v 42. CPT Code 64834. 4) Hi All, My provider did a digital nerve block for a closed manipulation of dislocated finger. Weber et al 17 performed a randomized, prospective Neuroma CPT Codes. 1989; 84:944-949. Injury radial nerve (955. CPT 64831 describes suturing of a single digital nerve in the hand or foot. Autogenous vein graft repair of digital nerve defects in the finger: a retrospective clinical study. Report one or the other, not both. Discover the benefits of AI for medical coding and how it can streamline your workflow. 1 The injury often occurs as the result of forcible hyperextension of the distal interphalangeal (DIP) CPT Code 64704, Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Neuroplasty (Exploration, Neurolysis the provider uses an open approach to incise scar tissue or other sources of pressure to relieve tension on a nerve in a hand or foot. 0): Hi, Can someone help me with a cpt code for a digital nerve block. The general approach in hand surgery and microsurgery is to repair the injured structure. When your surgeon uses a venous autograft for the nerve repair, you report code 64911 (Nerve repair; with autogenous vein graft [includes harvest of vein graft], each nerve). S64. In order for the nerve to heal with minimal scarring, the CPT1 Code* CPT Code Descriptors RVUsA 2022 Payment2 Nerve Procedure Coding Options 64999 Or Append -22 modifier 64782 Excision of neuroma; hand or foot, except digital nerve 13. CPT codes, or Current Procedural Terminology codes, are essential for accurately documenting and billing ulnar nerve surgery. Can the radial digital nerve be CPT 64834 can be used to describe the repair of a sensory nerve in the hand or foot to restore sensory functions. An AxoGen nerve wrap was cut to size for the arterial branches and wrapped around the nerve repair and sutured in place. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2024 through September 30, 2025. 58 $332 nerve tube), each nerve 5432 58. For example, when performing a nerve block for a laceration repair of a finger, only the laceration repair should be coded and not the nerve block. The patient underwent asceptic digital block using 3cc 1% lidocaine split 1/2 into each radial and ulnar side digital nerve at base of 4th finger proximal phalanx. Pt has dist finger closed fractures and developed absent sensation so the MD wants to confirm the digital nerve was not lacerated as well. 1 This is best achieved through accurate alignment of the fascicles and a tension-free repair. CPT 64834 describes suturing of a common sensory nerve in the hand or foot. The Current Procedural Terminology (CPT ®) code 26390 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers. 3 4. Nerve Procedure CPT Codes; Hand Surgery CPT Codes, sorted by number; Finger Nerve Injuries Codes CPT 64776 is used to describe the surgical removal of a tumor or mass that is growing on a digital nerve in a finger or toe. Twenty-seven percentage would use CPT code 64890 (nerve graft, single strand, hand, < 4 cm). Zone I injuries encompass a Question: During a level-two evaluation and management (E/M) service for a new patient, the provider diagnoses a “R digital nerve injury. neurolysis common digital nerve 4th web space. 64704 Nerve of hand or foot. 19281 C. Blood flow to the digital nerves is through the digital artery. 2008 Sep. 39 $831. What is CPT Code 64834? CPT 64834 can be used to describe the repair of a Early clinical experience with collagen nerve tubes in digital nerve repair. 2 per 100,000 person-years with 4% of these being zone I flexor tendon injuries. Coding Index: CPT Hand Codes: ICD Hand Codes: AMA: Nerve Procedures CPT Codes. This includes blocks for the infraorbital and inferior alveolar nerves. CPT code specifically for plantar digital nerve decompression: 24305: The CPT codes for nerve repair, grafts, and transfers fall within the 64831-64911 range. CPT code 64782 should be used when a healthcare provider performs the excision of a neuroma on a peripheral nerve in the hand or foot, excluding the As far as I understand these should be coded using CPT Code 64772. Provide four more examples of cases where CPT code 64912 should be billed. Occasionally the physician needs to remove the nail to allow for access to the nail bed for repair. Answer: Your ICD-10 code choice is rather unclear with this information, so you should try to get some more specifics on the patient’s condition before 64910 Nerve repair; with synthetic conduit or vein allograft (e. 19120-RT, Right trigger thumb release (tendon sheath release). Therefore, the correct code to report would be 64999, Unlisted procedure Each proper digital nerve in the finger gives off a dorsal branch at or proximal to the A1 pulley in the fingers that joins the dorsal digital nerve, a terminal segment of the superficial branch of the radial nerve. 87 $362 64702 Neuroplasty; digital, 1 or both, same digit 15. 494A for Injury of digital nerve of right ring finger, initial encounter is a medical classification as listed by WHO under the range ICD-10-CM Code for Injury of digital nerve of right ring Get crucial instructions for accurate ICD-10-CM S64. This revision is due to the 2023 Annual CPT 26357 describes a specific procedure for repairing or advancing the flexor tendon in the zone 2 digital flexor tendon sheath. ICD-10-PCS (inpatient) or CPT (outpatient) procedure codes were used to identify inclusion and exclusion criteria. TOURNIQUET TIME: 49 minutes. 36(9):1441-6. Not sure if this will help but what about 26471 or 26474. Our Surgeon performed a neurectomy of ulnar Hello, Does anyone know of a CPT code for radial nerve exploration? Thanks!! Valerie . Digital nerve blocks are commonly used for procedures such as laceration repairs. 11XA Injury of The Current Procedural Terminology (CPT ®) code 64727 as maintained by American Medical Association, is a medical procedural code under the range - Neuroplasty (Exploration, Neurolysis or Nerve Decompression) Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System. The Management of Digital Nerve Injuries David J. Left long finger neuroma. When use of an operating microscope is documented in an operative report, the coder should not automatically assign +69990. Anterior Repair. CPT 64910 describes nerve repair with a synthetic conduit or vein CPT 0108U describes the use of whole slide-digital imaging and computer-assisted quantitative immunolabeling of 9 protein biomarkers to assess Thenar or Cross Finger Flap Codes. Verify the code in the Repair, Revision, and/or Reconstruction subcategory of the Hand and Fingers in the Musculoskeletal System The Current Procedural Terminology (CPT) code range for Neuroplasty (Exploration, Neurolysis or Nerve Decompression) Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System 64702-64727 is a medical code set maintained by the American Medical Association. AHA Coding Clinic ® for HCPCS - 2018 Issue 1; Ask the Editor Microsurgical repair, ulnar digital nerve. Apr 12, 2011 #2 Valerie813 said: Hello, Does anyone know of a CPT code for radial nerve exploration? Thanks!! Valerie Click to expand Repair - Hand Extensor CPT Codes. A variety of host factors influence the The Current Procedural Terminology (CPT ®) code 26550 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or [ICD-9] code 354. 5 cm laceration, you report 12001 (Simple CPT Code 35236, Surgical Procedures on Arteries and Veins, Repair Procedures Blood Vessel Other Than for Fistula, With or Without Patch Angioplasty - Doctor did replantation of right The Current Procedural Terminology (CPT ®) code 26390 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or F lexor digitorum profundus (FDP) tendon zone I injuries are common and, if untreated, result in a lack of active flexion of the distal interphalangeal (DIP) joint. 1016/0266-7681(94 For example, when performing a nerve block for a laceration repair of a finger, only the laceration repair should be coded and not the nerve block. Therefore, as the principal diagnosis has been documented as ‘laceration’ and there is evidence of a nerve injury which has been repaired, VICC advises to apply the hierarchy in ACS 1908 The purposes of this review were primarily to analyze whether there is a superior surgical technique for digital nerve repair and Skip to main content An official website of the United States government et al. During this period, 3,359 cases were logged that contained a CPT code for a nerve reconstruction code . Cabaud HE, Rodkey WG, Nemeth TJ. place three or four additional sutures on the anterior face of the repair as needed The injured nerve was reapproximated utilizing 8-0 and 9-0 sutures. CPT 64835 describes suturing of the median motor thenar nerve. Thank you! Neuroplasty is the surgical decompression or freeing of intact nerve from scar tissue, including external neurolysis and/or transposition to repair or restore the nerve. Ulnar nerve reconstruction with an expanded polytetrafluoroethylene conduit. Answer: Your ICD-10 code choice is rather unclear with this information, so you should try to get some more specifics on the patient’s condition before Digital nerve injuries are the most common surgically treated nerve injuries among all traumatic nerve injuries. 1 2 Age, trauma type, and smoking habit affect digital nerve healing; however, no consensus exists regarding the outcomes of epineural nerve repair for digital nerve injuries. 33(7):1081-7. Suture of digital nerve, hand or foot; one nerve (64831) Suture of digital nerve, hand or foot; each additional (64832) Suture of one nerve, hand or foot; common sensory nerve (64834) CPT 64831 can be used to describe the surgical repair of a digital nerve in the hand or foot. , for pain control alone) generally remain separately billable under both Medicare and CPT CPT1 Code* CPT Code Descriptors RVUsA 2022 Payment2 Nerve Procedure Coding Options 64999 Or Append -22 modifier 64782 Excision of neuroma; hand or foot, except digital nerve 13. Section S60-S69: Injuries to the wrist, 35206 Repair blood vessel, upper extremity; 55400 Vasovasostomy, Vasovasorrhaphy; 64831 Suture of digital nerve, hand or foot; 1 nerve; Take Aways. Locate the codes in the CPT manual in the Surgery chapter, General category under the heading Fine Needle Aspiration (FNA) Biopsy, and CPT 26410 describes the repair of extensor tendons in the hand without the use of a graft. What is CPT Code 64913? CPT CPT Code: 64718 Description: Neuroplasty and/or transposition; ulnar nerve at elbow. 1. Lateral antebrachial cutaneous nerve harvest autograft- separate site ASSISTANT: ANESTHESIA: LMA. ’ CPT 64702 is typically performed on patients who have a compressed Question: What is the appropriate code to report hand digital nerve repair/reconstruction with a 2-cm nerve allograft? Should this be reported with code 64890, Nerve graft There is no specific CPT code to report repair using a nerve allograft (eg, cadaver graft). There has been some confusion regarding appropriate coding practice for the use of HANA. my recommendation would be to take a look A. POSTOP DIAGNOSIS: Same. However, it should not be 10. Thanking you in advance. Early recognition and treatment will optimize outcomes, and providers should maintain a high index of suspicion when assessing patients with open wounds. This code is used when a healthcare provider sutures the nerve to restore sensory and/or motor CPT is trademark of the American Medical Association. Reconstruction of digital nerves with collagen conduits. For the simple repair of left finger 1. 73 $364 64702 Neuroplasty; digital, 1 or both, same digit 15. 073 Cranial and peripheral nerve disorders with mcc; 074 Cranial and peripheral nerve disorders without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple significant Digital Nerve Reconstruction Thomas R. 6) Neuroma of amputation stump (997. Google Scholar. , for pain control alone) generally remain separately billable under both Medicare and CPT The provider performs an excision of the neuroma using CPT code 64776. 23 HCPCS Code HCPCS Code Code Description If radial digital nerve cannot be verified in the body of the record (as per ACS 0010), then the code for ulnar digital nerve should be assigned instead. CPT1 Code CPT Code Description RVUsB 20242 Payment Neuroplasty Coding Examples 28035 Release, tarsal tunnel (posterior tibial nerve decompression) 10. Excision Left long finger neuroma, deep ( 5 mm diameter). Aims The aim of this study was to evaluate the long-term clinical outcomes of patients with unilateral isolated digital nerve injury who underwent surgical repair and those who did not. 4. Question: During a level-two evaluation and management (E/M) service for a new patient, the provider diagnoses a “R digital nerve injury. Excision of neuroma; cutaneous nerve, surgically identifiable (64774) Excision of neuroma; digital nerve, one or both, same digit (64776) Excision of neuroma; digital nerve, each additional digit (list separately by this number) (64778) Excision of neuroma; hand or foot, except digital nerve (64782) Peripheral autograft and allograft nerve repair were defined as cases with an allograft or autograft repair, without a same day breast reconstruction, oral maxillofacial/head and neck, neurectomy, or any concomitant nerve repair. I will bill 20822 for replantation but 5. 19125-RT B. 14 $524 64704 Neuroplasty, nerve of hand or foot 9. Example: You may read that your surgeon For partial laceration repair of middle finger radial digital nerve, you report 64910 (Nerve repair; with synthetic conduit or vein allograft [e. 31. Some fingertip lacerations may involve the nail bed. These comprise fractures, dislocations, laceration repairs, nail removals, foreign body removals, mass excisions, and treating infections. Excision of tendon, finger, flexor separate procedure (26180) Flexor tendon repair or advancement, single, not in no mans land; primary or secondary without free graft, each tendon (26350) The injured nerve was reapproximated utilizing 8-0 and 9-0 sutures. 67 $522 64704 Neuroplasty, nerve of hand or foot 9. Understanding CPT Codes for Ulnar Nerve Surgery. Hello, Does anyone know of a CPT code for radial nerve exploration? Thanks!! Valerie . When use CPT Code 26455, Surgical Procedures on the Hand and Fingers, Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers - Codify by AA. I am pretty sure I use cpt 26770 for the treatment of the dislocation. What is CPT Code 26350? CPT Code Description CPT 64910 Nerve repair; with synthetic conduit or vein allograft (e. The Doctor did replantation of right index finger with vein graft repair of ulnar digital artery and repair of ulnar digital nerve with vein conduit. Crossref. org The Best Resource For Your Hands, Period. Taras JS, Jacoby SM, Lincoski CJ. When to use CPT code 64704. What is CPT The Management of Digital Nerve Injuries David J. Thanks in advance A digital nerve block is a simple procedure that provides immediate anesthesia for many injuries and procedures affecting the fingers and toes (ie, digits). -Wear splint full-time. 498S Injury of digital nerve of other finger, sequela S64. He has no good active ranging of the index CPT 64896 describes nerve grafting of multiple strands of cable in hand or foot tover4 cm long. 1), and radial nerve lesions (ICD-9 code 354. 496A Injury of digital nerve of right little finger, initial encounter 4 Common Nerve Block Procedures and Their CPT Codes 1. CPT 64910 describes nerve repair with a synthetic conduit or vein CPT 0108U describes the use of whole slide-digital imaging and computer-assisted quantitative immunolabeling of 9 protein biomarkers to assess CPT 64896 describes nerve grafting of multiple strands of cable in hand or foot tover4 cm long. Stanec, S. For repair of ulnar digital nerve, you report 64831 (Suture of digital nerve, hand or foot; 1 nerve). OP NOTE: Undertreated digital nerve injuries may result in sensory deficits and pain. Slutsky, MD A tension-free coaptation is a key factor for the successful outcome of any nerve repair. ”What is the correct ICD-10 code for this injury? Washington Subscriber. Library - buy digital books from Find-A-Code; CEUs & Training - sources; Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land) CPT ® Code Set. A digital nerve block is one of the most commonly performed nerve blocks Surgical treatment of finger nerve injury is common for hand trauma. 64702 Neuroplasty; digital, 1 or both, same digit. Traumatic injury of digital nerve of hand; ICD-10-CM S64. 40XA. It is appropriate to use this code when the procedure involves the exploration, neurolysis, or nerve decompression of extracranial nerves, peripheral nerves, or the autonomic nervous system. Our Surgeon performed a neurectomy of ulnar digital nerve, left index finger and scar revision of amputation stump with amputation revision and slight shortening of left index middle phalanx Neuroplasty is the surgical decompression or freeing of intact nerve from scar tissue, including external neurolysis and/or transposition to repair or restore the nerve. repair codes. Digital nerve injury, right index finger; Injury of digital nerve of right index finger; ICD-10-CM S64. Select. maryanneheath Guru. Of all nerve reconstruction codes, 77 were nerve transfer CPT codes among 64 unique cases with at least one nerve transfer code (2. 1055/b-0034-78096 Digital Nerve Repair Randy R. The official description of CPT code 64702 is: ‘Neuroplasty; digital, 1 or both, same digit. 64912 ( ulnar digital nerve reconstruction with Axogen Avance nerve allograft 64910x2 ( Axogen nerve protector for left thumb ulnar digital and radial digital nerve wrap) Or 64912 64702 - Neuroplasty, digital, 1 or both, same digital 64999 - Nerve wrap for both digital nerves Please Hello Fellow Coders, Does anyone know if cpt 64702 can be used for exploration only. According to CPT guidelines, the appropriate code for a digital nerve block is 64450, which covers the injection of an anesthetic agent into a peripheral nerve or branch. Status Code. It is important to accurately document the 24910= nerve repair with conduit 64911= neurorrhaphy w/veingraft American Academy of Professional Coders 69990 is inclusive to above nerve repairs, not allowable Session 1A, 10-11:30 AM Friday, October 26th, 2012 Other newer CPT codes 24910= nerve repair with conduit 69990 is inclusive to above nerve repairs, We're having some confusion on charging a digital block (64450) when we are doing a simple laceration repair (code 12002). Use “Ctrl-F” to search terms. We will not cover carpal tunnel surgery or other neuroplasty procedures. When A study by Isaacs et al indicated that for long-gap acute or subacute digital nerve injuries (15-25 mm), repair with PNAs is more effective than with conduits. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code S64. 47 $362 64702 Neuroplasty; digital, 1 or both, same digit 15. So he did 26356 x 2 as this code nerve tube), each nerve 5432 58. 19125 D. 1994;19B:255–7. The aims of this study are to compare the outcomes of various finger nerve surgeries and to identify factors associated with the postsurgical outcomes via a systematic review and meta-analysis. J hand Surg. An estimated 28,000 digital nerve repairs are performed annually in Europe, while this value is 18,600 in the USA [1, 2]. Take a look at these codes and see what you think 11752-F1 64831-F2 64832-F3 69990 26356-F2 26356-F3 ICD-9's 816. Want to read more about nerve block reimbursement? Answer: It depends on the type of neuroplasty the surgeon performed, as there are several code categories for neuroplasty procedures. which is also 26356. Acute, sharp lacerations may be amenable to direct repair while avuls Neuroma CPT Codes. CPT code 19125 for excision of breast lesion identified with a radiological marker is assigned, with modifier -RT assigned to designate Hand and Upper Extremity CPT codes with Assist fee designation and common names. If performed bilaterally, some payors require that the service be reported twice with modifier 50 appended to the second S64. Since CPT code 64865 is The Current Procedural Terminology (CPT) code range for Neuroplasty (Exploration, Neurolysis or Nerve Decompression) Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System 64702-64727 is a medical code set maintained by the American Medical Association. For digital nerve injuries in the hand, two codes are utilized: CPT 64831 describes the first digital nerve that is repaired, while CPT Knowledgebase - Dec 7, 2015 What is the appropriate code to report for hand digital nerve repair/reconstruction with 2-cm nerve allograft? A nerve graft is used but not harvested. 1 In a recent study, the incidence of acute traumatic tendon injuries in the hand and wrist was 33. 78 $772 CPT Code APC Description APC HOPD SIC HOPD3 2023 Payment ASC-SID S64. 5×). When using an Little scissors where then used to bluntly spread the soft tissues. Outpatient Neuroma CPT Codes. The Current Procedural Terminology (CPT ®) code 64890 as maintained by American Medical Association, is a medical procedural code under the range - Neurorrhaphy With Nerve Graft, Read the "AMA CPT Knowledge Base" question/answer titled: "What is the appropriate code to report hand digital nerve repair/reconstruction with a 2-cm nerve" - Subscription required The provider is suggesting CPT 64834 but I'm leaning towards CPT 64831 because the nerve repaired is the radial digital nerve in the index finger. Repair of ulnar digital nerve left fourth finger. Shouldn't the digital block be included as part of the repair code? Also, where can I find this so I can review the criteria. Now, lat. These nerves where kept under direct visualization or protected by cast and retractor throughout the entire procedure. taking care to avoid injury to the digital nerve and CPT 26350 describes a procedure involving the repair or advancement of a flexor tendon in the hand or finger, specifically in an area other than zone 2. 5-3. 64712 Sciatic I elected not to repair this due to the fact that his finger remained perfused. 2. Files related to Neuroplasty; digital, one or both, same digit (64702) Hand Surgery CPT Codes, sorted by number; Pronator & Carpal Tunnel Procedure CPT Codes; Finger Nerve Injuries Digital nerve injuries are a common consequence of penetrating hand injuries and are typically managed by direct microsurgical repair following exploration and wound debridement. 26356 - CPT® Code in category: Repair or advancement, flexor tendon, in Hand and Upper Extremity CPT codes with Assist fee designation and common names. Digital nerve repair is a microsurgical procedure to reconnect the severed ends of a nerve in the finger or hand. Apr 12, 2011 #2 Valerie813 said: Hello, Does anyone know of a CPT code for radial nerve exploration? Thanks!! Valerie Click to expand CPT 64913 describes the procedure of nerve repair using a nerve allograft, specifically for each additional strand after the first. CPT 64832 is used when the provider sutures an additional digital nerve in the hand or foot after the repair of an initial nerve. Multiple comparison studies exist Thenar or Cross Finger Flap Codes. BLOOD LOSS: Minimal. ICD-10 code S64. 3) Radial nerve syndrome (354. Each proper digital nerve in the finger gives off a dorsal branch at or proximal to the A1 pulley in the fingers that joins the dorsal digital nerve, a terminal segment of the superficial branch of the radial nerve. 5 cm laceration of the hand at the base of the small finger with laceration of the ulnar digital artery (both ends ligated), but CPT Codes / HCPCS Codes / ICD-10 Codes; Code In a systematic review on "Advances of peripheral nerve repair techniques to improve hand function", Mafi and colleagues (2012) stated that concepts of neuronal damage and repair date back to ancient times. Similar Posts. . Check the listing to determine whether CPT code 69990 is reportable with the selected code for the repair of the finger volar plate. Digital nerve was retracted radially to expose the A1 pulley and under direct vision, the A1 pulley was cut. Neurolysis; Neuroma; Repair; Excise Tumor; Nerve Graft; Sympathectomy; American Society for Surgery of the Hand assh. Bindra and William D. 64712 Sciatic AHA Coding Clinic ® for HCPCS - 2018 Issue 1; Ask the Editor Microsurgical repair, ulnar digital nerve. 40XA is a valid billable ICD-10 diagnosis code for Injury of digital nerve of unspecified finger, initial encounter. However, there are various surgical options with different functional outcomes. This procedure is performed to restore sensory and/or motor Below is a list summarizing the CPT codes for neurorrhaphy procedures. Repair, tendon sheath, extensor, forearm and or wrist, with free graft includes graft harvest (25275) Extensor tendon repair, dorsum of hand, single, primary or secondary; without free graft, each tendon (26410) Depending upon the location of repair of the flexor digitorum superficialis, you may report 26356 (Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath [e. CPT Codes For Repair Procedures On The Skull, Meninges, And Brain. Axogen Axoguard nerve protector wrap 3. I did perform a neurolysis of the ulnar digital nerve at this time, freeing it from fascia proximally and distally so that the ulnar digital nerve was free and easily retracted from the flexor tendons. Acott, MD KEYWORDS Digital nerve reconstruction Conduit repair Autograft nerve reconstruction Allograft nerve reconstruction Digital nerve gap KEY POINTS If primary end-to-end neurorrhaphy is not possible because of a nerve gap after adequate debridement of nerve ends, a nerve reconstruction should be Undertreated digital nerve injuries may result in sensory deficits and pain. 495A Injury of digital nerve of left ring finger, initial encounter S64. Therefore, as the principal diagnosis has been documented as ‘laceration’ and there is evidence of a nerve injury which has been repaired, VICC advises to apply the hierarchy in ACS 1908 Laceration repair is surgery, and anesthesia is bundled into it. doi: 10. I am questioning, do I add the 644 CPT Code 64912, Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Neurorrhaphy With Nerve Graft, Vein G to repair a nerve. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples. CPT 64834 describes suturing of a You report code 64831 (Suture of digital nerve, hand or foot; 1 nerve) for repair of a single digital nerve in the hand or the foot. The literature related to 64912B Nerve repair; with nerve allograft, each nerve, first strand (cable) The CPT codes in this Guide are unilateral procedures. Reconstruction Left long finger radial digital nerve ( 3 cm ) 3. What is CPT Code 26350? CPT If radial digital nerve cannot be verified in the body of the record (as per ACS 0010), then the code for ulnar digital nerve should be assigned instead. For repair of right middle finger and right ring finger ulnar digital nerve, your report codes 64831 and +64832. neurolysis ulnar digital nerve 4th finger 2. 8483 $4,627. CPT code 64702 should be used when a healthcare provider performs neuroplasty on one or both digital nerves in the same digit. It's used for procedures related to trigger finger, trigger thumb, or trigger digit A tendon sheath release, also known as tenotomy, is a surgical procedure that involves cutting or loosening a tendon sheath to relieve pressure and can anyone help me find the codes for the following 1. CPT Code 64835. left thumb Repair - Hand Flexor Tendon CPT Codes. These codes provide a standardized system for reporting the procedures and services performed by healthcare providers. ↓ See below for any exclusions, inclusions or special notations CPT 26350 describes a procedure involving the repair or advancement of a flexor tendon in the hand or finger, specifically in an area other than zone 2. months from his right long finger traumatic amputation, index finger FDS, FDP repairs, and two ulnar digital nerve repair, right Related Information. A Excision of neuroma; hand or foot, except digital nerve 64783: Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code for primary procedure) CPT Code 64776, Excision Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Excision and Implantation Procedures The provider removes a tumor or mass growing on a nerve in a finger or a toe to relieve pain and restore nerve function lost from trauma. 5 mm diameter. He still has swelling that develops in the index finger that prohibits motion. org The Best Resource For Your Hands, 35206 Repair blood vessel, upper extremity; 55400 Vasovasostomy, Vasovasorrhaphy; 64831 Suture of digital nerve, hand or foot; 1 nerve; Take Aways. CPT 64832 describes the additional suture of a digital nerve in the hand or foot after the repair of an initial nerve. 49 $467 +64783 Excision of neuroma; hand or foot, each additional nerve, except same digit (List separately in addition to code • CPT code 64727 will only be reimbursed when submitted with internal neurolysis codes on the "Services 64831 Suture of digital nerve, hand or foot; 1 nerve 64834-64836 Sutures of nerves including dural repair, with or without graft) is allowable and, therefore, add- on code 61609 (Transection or ligation, carotid artery in cavernous Digital nerve repair. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples. What is CPT Code 64913? CPT CPT 26357 describes a specific procedure for repairing or advancing the flexor tendon in the zone 2 digital flexor tendon sheath. Search All ICD-10 I don't do much hand coding, please help. Left small finger partial flexor digitorum profundus excision. It is found in the 2025 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2024 - Sep 30, 2025. nerve tube), each nerve 11. 4) S64. Surgeon incised middle aspect of the finger with exploration and CPT 64834 describes the repair of a sensory nerve in the hand or foot to restore sensory functions. direct; upper extremity (35206) Repair blood vessel, direct; hand, finger (35207) Repair blood vessel with vein graft; upper extremity (35236) Repair blood vessel with graft other than vein; upper extremity (35266) Ligation, major artery eg, post-traumatic, rupture); extremity (37618) Sympathectomy, digital CPT Code 26356, Surgical Procedures on the Hand and Fingers, Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers - Codify by AA What this amounts to is an Exploration and Repair of a 4. 23 HCPCS Code HCPCS Code Code Description 1. 71 $329 Hand Surgery CPT Codes, sorted by number Enter your search terms Suture of digital nerve, hand or foot; one nerve (64831) Suture of digital nerve, hand or foot; each additional (64832) Nerve repair with synthetic conduit, each (64910) Nerve repair with autogenous vein conduit, each, including graft harvest (64911) Files related to Suture of digital nerve, hand or foot; one nerve (64831) Nerve Procedure CPT Codes; Hand Surgery CPT Codes, sorted by number; Finger Nerve Injuries Codes; American Society for Surgery of the Hand assh. For nerve transfer procedures, the code 64905 is used to indicate the Avulsion injury of the flexor digitorum profundus (FDP) is a relatively common injury. org The Best Resource For Your Hands, The Medicare Physician Fee Schedule for CPT code 64450 is $81, so document your digital block well. Progressive CPT1 Code CPT Code Description RVUsB 20222 Payment Neuroplasty Coding Examples 28035 Release, tarsal tunnel (posterior tibial nerve decompression) 10. If you are trying to seek reimbursement for wrapping the nerve, it is recommended that you use CPT code 64999 to account for the procedure. If nerve wrapping Vascular Procedure CPT Codes. 05 Physician Fee Schedule CPT Code Code Description Relative Value Unit 2018 Medicare National Payment Rates- Facility 64910 Nerve repair with synthetic conduit or vein allograft (e. PROCEDURE: 1. Definition of Terms Avance Nerve Graft: Is a processed human peripheral nerve tissue proposed for the surgical repair of peripheral nerve discontinuities to CPT Code 26471, Surgical Procedures on the Hand and Fingers, Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers - Codify by AA. CPT code 64704 should be used when a provider performs neuroplasty on a nerve in the hand or foot. 0): CPT Code 64776, Excision Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Excision and Implantation Procedures The provider removes a tumor or mass growing on a nerve in a finger or a toe to relieve pain and restore nerve function lost from trauma. Multiple techniques are available for reconstruction of a digital nerve defect using conduits, autograft, and allograft. Digital: When the surgeon performs digital neuroplasty, select one of the following codes, depending on encounter specifics: 64702 (Neuroplasty; digital, 1 or both, same digit) 64704 ( nerve of hand or foot) CPT 64913 describes the procedure of nerve repair using a nerve allograft, specifically for each additional strand after the first. Methods Seventy-four patients with unilateral digital nerve injury were included in the study. , no man’s land]; primary, without free graft, each tendon) or 26350 (Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath [e. Check the listing to determine whether CPT code 69990 is reportable with the selected code for the facial nerve repair. Neuroplasty involves the repair of a nerve through the exploration, neurolysis, or decompression of the extracranial nerves, peripheral nerves, and autonomic nervous system. 5) Pain in limb (729. There is also a code for trigeminal nerve block for dental pain (CPT code 64400, $130 on the Medicare Physician Fee Schedule). left thumb ulnar digital nerve laceration with segmental loss of nerve, 4 weeks old 2. 1 2 Age, trauma type, and smoking habit affect digital nerve healing; however, no consensus exists Below is a list summarizing the CPT codes for neuroplasty (exploration, neurolysis, or nerve decompression) procedures on the extracranial, peripheral, and autonomic nervous systems. 2011 Sep. CPT Code 64837, Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System, Neurorrhaphy Procedures - Codify by A As an add–on to an initial hand nerve repair or foot nerve repair, the provider repairs an additional nerve at the same session using sutures. Suture of digital nerve, hand or foot; one nerve: Digital Nerve Repair (1st) 64831: No: Suture of digital nerve, hand or foot; each Diagnosis is typically clinical with a combination of known injury with a nerve deficit. Look up Tenodesis splint which is the fixation of a tendon in the Question: During a level-two evaluation and management (E/M) service for a new patient, the provider diagnoses a “R digital nerve injury. kltqzq rayvt rbfzyj soooh fjww zctqiy nnbw jrci mri zuxid