Neurology & Pain Management Coding Alert

Question: I’m new to PM coding and I’ve been trying to get up to speed on the CPT^® codes my clinicians use most often. One of the areas I’m struggling with is the difference between digital neuroplasty and neuroplasty of a major peripheral nerve. I don’t understand the code descriptor for digital neuroplasty, especially. Can you help?

Colorado Subscriber

Answer: The code for digital neuroplasty, 64702 (Neuroplasty; digital, 1 or both, same digit), is a little tricky. “Digital” in the descriptor refers to the digital nerves of the fingers and toes; report 64702 when your PM specialist performs neuroplasty on a patient’s finger or toe. The “1 or both” in the descriptor refers to the number of nerves the provider treats in the digit (there are two digital nerves in each digit).

So, if notes indicate that the PM specialist performed a digital neuroplasty on both nerves of a patient’s right pinky, you’d report 64702 for the service.

For a neuroplasty in a patient’s hand or foot, you should opt for 64704 (… nerve of hand or foot).

Major peripheral neuroplasties: When your provider performs a neuroplasty on a patient’s peripheral nerve, arm, or leg, you’ll choose from one of the following codes:

• 64708 — Neuroplasty, major peripheral nerve, arm or leg, open; other than specified
• 64712 — … sciatic nerve
• 64713 — … brachial plexus
• 64714 — … lumbar plexus.