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Nerve procedure

Kerry Posted Fri 16th of November, 2018 09:20:56 AM
The physician performs decompression fasciotomy of the right thigh and then neuroplasty of the right lateral femoral cutaneous nerve with the excision of a neuroma. The end of the nerve was then repaired with the amniotic membrane used as a synthetic conduit. The right lateral femoral cutaneous nerve was then implanted into the surrounding muscle. Can these codes be coded for the procedure of the right thigh decompression and right femoral cutaneous nerve? 27946 for the decompression fasciotomy; 64910 for the conduit; 64784 for the neuroma excision; 64787 for nerve implantation into the muscle.
SuperCoder Answered Mon 19th of November, 2018 06:25:27 AM

For decompression fasciotomy thigh you can select the code from the code range 27496-27497 (One Compartment) and 27498-27499 (multiple compartments) with and without debridement of nonviable muscle and/or nerve. Check your complete op report and select the appropriate code out of the suggested code ranges.

64910 is correct for nerve repair; with synthetic conduit or vein allograft (eg, nerve tube) and CPT 64784 excision of neuroma. Code 64784 is a column 2 code for 64910, modifier 59 is allowed in order to differentiate between the services provided. Hence, use modifier 59 with code 64784. CPT 64787 can be coded separately in addition to neuroma excision when implantation of nerve end into bone or muscle.

Also, use modifier RT as laterality modifier.

Hope this helps!

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