AHA Coding Clinic® for HCPCS - 2015 Issue 3; ASK THE EDITOR

Complete neurolysis

Complete neurolysis of the nerve was carried out from the flexor carpi ulnaris (FCU) fascia, through the previous transposition zone to the triceps. The previous anastomosis site was taken down; the previous neural tube graft was resected, and a new cadaveric graft (Avance human nerve tissue allograft) was sutured into position. 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. We were not sure if CPT code 64910, Nerve repair; with synthetic conduit or vein allograft (e.g., nerve tube), each nerve, was appropriate because a synthetic conduit or vein allograft (e.g., nerve tube) was not used this time. There is also confusion as to whether the neurolysis CPT code 64718, Neuroplasty and/or transposition; ulnar nerve at elbow, should be coded separately in this case.  ...

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