Neurosurgery Coding Alert

Reader Question:

Branch Order Determines Nerve Destruction Codes

Question: How should I report the destruction of three separate branches (supraorbital, infraorbital and inferior alveolar) of the trigeminal nerve?

Georgia Subscriber

Answer: You should claim 64600 (Destruction by neurolytic agent, trigeminal nerve, supraorbital, intraorbital, mental, or inferior alveolar branch) for the first (initial) branch. For the second and third branches, report a single unit of either 64605 (...second and third division braches at foramen ovale) or 64610 (...second and third division branches at foramen ovale under radiologic monitoring), depending on whether the surgeon uses radiologic monitoring.

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