Neurosurgery Coding Alert

Question: What is the proper coding for surgical treatment of carpal tunnel syndrome?

Iowa Subscriber

 
Answer: Surgical treatment of carpal tunnel syndrome (CTS, 354.0) is reported using 64721 (neuroplasty and/or transposition; median nerve at carpal tunnel). On occasion, the surgeon may also compress the ulnar nerve at Guyons canal (64719, neuroplasty and/or transposition; ulnar nerve at wrist) to treat ulnar nerve syndrome (354.2), multiple neuritis syndrome (354.5) or injury to the ulnar nerve (955.2) during the session. This procedure may be reported separately. If your carrier requires modifier -51 (multiple procedures) when billing more than one procedure, append the modifier to the lesser-valued of the two codes -- in this case, 64719 (10.2 relative value units [RVUs] versus 10.38 RVUs for 64721).