# PIN Neurectomy



## TnRushFan (Aug 19, 2019)

Good morning folks,

My surgeon routinely does PIN neurectomy [64772] along with carpal tunnel or ganglion procedures and indicates it is for post operative pain control. 
Can this be coded separately? I have found several references indicating that it cannot be coded separately without separate pathology for the nerve. This is a major conversation at our facility right now.


*SuperCoder*
The posterior interosseous nerve travels along the posterior aspect of the forearm between the ulna and the radius. The posterior interosseous has its roots in the cervical spine (C6, C7, C8) and arises as a branch from the radial nerve.CPT has several codes (64732-64772) relating to the excision or transection of the nerves. The origin of the nerve root must be known to reference the proper CPT code. You must also check to see whether the excision/transection is being performed for postoperative pain control. The Centers for Medicare and Medicaid Services has stated that the global surgical package includes postoperative pain management by the surgeon (see 100-04 Claims Processing Section 40).
The documentation must clearly show why the nerve is being excised/transected. The recommended code for these excisions is 64772.
*American Association Of Surgeons Bulletin*
The posterior interosseous nerve travels along the posterior aspect of the forearm between the ulna and the radius. The posterior interosseous has its roots in the cervical spine (C6, C7, C8) and arises as a branch from the radial nerve.
Coding: You must also check to see whether the excision/transection is being performed for postoperative pain control. The Centers for Medicare and Medicaid Services has stated that the global surgical package includes postoperative pain management by the surgeon. The documentation must clearly show why the nerve is being excised/transected.

Any guidance will be appreciated.


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## TnRushFan (Aug 20, 2019)

Okay folks, I finally got him to understand that it bundles in for post op pain control...does anyone know any documentation tips that we can use to be able to capture these? Can he document "hand pain" or something like that? Does it still bundle in if the pain is secondary to the ganglion?

Thanks in advance...


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