Neurosurgery Coding Alert

Question: Encounter notes indicate that the surgeon performed a neuroplasty. How should I code for the service?

Nebraska Subscriber

Answer: It depends on the type of neuroplasty the surgeon performed, as there are several code categories for neuroplasty procedures.

Digital: When the surgeon performs digital neuroplasty, select one of the following codes, depending on encounter specifics:

• 64702 (Neuroplasty; digital, 1 or both, same digit)
• 64704 (… nerve of hand or foot)

Major peripheral nerve: When the surgeon performs neuroplasty on a major peripheral nerve, select one of the following codes depending on encounter specifics:

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

Neuroplasty and/or transposition: When the surgeon performs neuroplasty and/or transposition, select one of the following codes depending on encounter specifics:

• 64716 (Neuroplasty and/or transposition; cranial nerve (specify))
• 64718 (… ulnar nerve at elbow)
• 64719 (… ulnar nerve at wrist)
• 64721 (… median nerve at carpal tunnel).