ICD-10-PCS Code For Accessory Nerve: Procedure Code Group Overview

The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) code group 00XR includes procedures performed to transfer nerves or neural structures in the central nervous system and cranial nerves. These ICD-10-PCS codes are used for inpatient documentation when a portion or all of the accessory nerve is moved to assume the function of another nerve or neural structure. Accurate coding within the ICD-10-PCS 00XR group is essential for proper inpatient reimbursement, as it captures procedure performed and determines appropriate case mix and payment.

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Accessory Nerve Transfer Procedure Overview

Procedures in this group involve transferring all or a portion of the accessory nerve within the central nervous system and cranial nerves to take over the function of another nerve or neural structure. These operations are classified under the Medical and Surgical section of the International Classification of Diseases, Tenth Revision, Procedure Coding System and involve a transfer root operation. Accurate coding of accessory nerve transfer procedures is important for inpatient reimbursement because it captures the specific neural reconstruction performed and supports proper case mix assignment and payment.

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
0	Section	Medical and Surgical
0	Body System	Central Nervous System and Cranial Nerves
X	Operation	Transfer
R	Body Part	Accessory Nerve

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ICD-10-PCS Code For Accessory Nerve: Procedure Code Group Overview

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Accessory Nerve Transfer Procedure Overview

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
0	Section	Medical and Surgical
0	Body System	Central Nervous System and Cranial Nerves
X	Operation	Transfer
R	Body Part	Accessory Nerve

When to Use

Use a code from this group when the accessory nerve is surgically moved without removal to restore or replace function of another nerve or neural structure. These codes apply when the operative intent is transfer rather than excision, repair, or replacement.

ICD-10-PCS Codes

24 rows

ICD-10-PCS Code	Description
00XR0ZF	Transfer Accessory Nerve to Olfactory Nerve, Open Approach
00XR0ZG	Transfer Accessory Nerve to Optic Nerve, Open Approach
00XR0ZH	Transfer Accessory Nerve to Oculomotor Nerve, Open Approach
00XR0ZJ	Transfer Accessory Nerve to Trochlear Nerve, Open Approach
00XR0ZK	Transfer Accessory Nerve to Trigeminal Nerve, Open Approach
00XR0ZL	Transfer Accessory Nerve to Abducens Nerve, Open Approach
00XR0ZM	Transfer Accessory Nerve to Facial Nerve, Open Approach
00XR0ZN	Transfer Accessory Nerve to Acoustic Nerve, Open Approach
00XR0ZP	Transfer Accessory Nerve to Glossopharyngeal Nerve, Open Approach
00XR0ZQ	Transfer Accessory Nerve to Vagus Nerve, Open Approach

Showing 1–10 of 24

DRG Codes

12 rows

DRG Code	Description
040	Peripheral, Cranial Nerve and Other Nervous System Procedures with MCC
041	Peripheral, Cranial Nerve and Other Nervous System Procedures with CC or Peripheral Neurostimulator
042	Peripheral, Cranial Nerve and Other Nervous System Procedures without CC/MCC
143	Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC
144	Other Ear, Nose, Mouth and Throat O.R. Procedures with CC
145	Other Ear, Nose, Mouth and Throat O.R. Procedures without CC/MCC
907	Other O.R. Procedures for Injuries with MCC
908	Other O.R. Procedures for Injuries with CC
909	Other O.R. Procedures for Injuries without CC/MCC
957	Other O.R. Procedures for Multiple Significant Trauma with MCC

Showing 1–10 of 12

Typical Clinical Scenarios

Planned elective peripheral nerve reconstruction for a patient with isolated unilateral trapezius paralysis after prior radical neck dissection resulting in loss of accessory nerve function. The surgical team transfers a viable segment of the accessory nerve to reinnervate the spinal accessory distribution of the affected side to restore shoulder elevation and scapular stabilization. The procedure is scheduled as an inpatient elective neurotologic reconstruction using an open approach. Typical codes: 00XR0ZR
Acute traumatic posterior cervical injury from penetrating neck trauma with partial disruption of the accessory nerve resulting in immediate profound trapezius weakness and shoulder droop. During the same inpatient operative session the surgeon mobilizes and transfers a portion of the accessory nerve to reestablish continuity and assume function of the injured cranial nerve branch via an open surgical transfer to restore motor function. Typical codes: 00XR0ZR
Revision procedure for failed prior nerve repair with persistent denervation of shoulder musculature and synkinesis after initial reconstruction; surgeon performs a secondary transfer of accessory nerve fibers to the facial nerve region to improve motor control of neck and shoulder movements and to address functional deficits. The operation is performed inpatient and uses a percutaneous endoscopic approach to mobilize and re-route the accessory nerve to the target cranial nerve. Typical codes: 00XR4ZM

Related Codes

00XF-OLFACTORY-NERVE-TRANSFER

ICD-10-PCS Code for Olfactory Nerve: Procedure Code Group Overview

00XG-OPTIC-NERVE-TRANSFER

ICD-10-PCS Code For Optic Nerve: Procedure Code Group Overview

00XH-OCULOMOTOR-NERVE-TRANSFER

ICD-10-PCS Code For Oculomotor Nerve: Procedure Code Group Overview

00XJ-TROCHLEAR-NERVE-TRANSFER

ICD-10-PCS Code For Trochlear Nerve: Procedure Code Group Overview

00XK-TRIGEMINAL-NERVE-TRANSFER

ICD-10-PCS Code For Trigeminal Nerve: Procedure Code Group Overview

00XL-ABDUCENS-NERVE-TRANSFER

ICD-10-PCS Code For Abducens Nerve: Procedure Code Group Overview

00XM-FACIAL-NERVE-MOVING-FACIAL-NERVE-TRANSFER

ICD-10-PCS Code For Facial Nerve: Procedure Code Group Overview

00XN-ACOUSTIC-NERVE-TRANSFER

ICD-10-PCS Code For Acoustic Nerve: Procedure Code Group Overview

00XP-GLOSSOPHARYNGEAL-NERVE-TRANSFER

ICD-10-PCS Code For Glossopharyngeal Nerve: Procedure Code Group Overview

00XQ-VAGUS-NERVE-TRANSFER

ICD-10-PCS Code For Vagus Nerve: Procedure Code Group Overview

Showing 1–10 of 11

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-PCS Codes

24 rows

ICD-10-PCS Code	Description
00XR0ZF	Transfer Accessory Nerve to Olfactory Nerve, Open Approach
00XR0ZG	Transfer Accessory Nerve to Optic Nerve, Open Approach
00XR0ZH	Transfer Accessory Nerve to Oculomotor Nerve, Open Approach
00XR0ZJ	Transfer Accessory Nerve to Trochlear Nerve, Open Approach
00XR0ZK	Transfer Accessory Nerve to Trigeminal Nerve, Open Approach
00XR0ZL	Transfer Accessory Nerve to Abducens Nerve, Open Approach
00XR0ZM	Transfer Accessory Nerve to Facial Nerve, Open Approach
00XR0ZN	Transfer Accessory Nerve to Acoustic Nerve, Open Approach
00XR0ZP	Transfer Accessory Nerve to Glossopharyngeal Nerve, Open Approach
00XR0ZQ	Transfer Accessory Nerve to Vagus Nerve, Open Approach

Showing 1–10 of 24

DRG Codes

12 rows

DRG Code	Description
040	Peripheral, Cranial Nerve and Other Nervous System Procedures with MCC
041	Peripheral, Cranial Nerve and Other Nervous System Procedures with CC or Peripheral Neurostimulator
042	Peripheral, Cranial Nerve and Other Nervous System Procedures without CC/MCC
143	Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC
144	Other Ear, Nose, Mouth and Throat O.R. Procedures with CC
145	Other Ear, Nose, Mouth and Throat O.R. Procedures without CC/MCC
907	Other O.R. Procedures for Injuries with MCC
908	Other O.R. Procedures for Injuries with CC
909	Other O.R. Procedures for Injuries without CC/MCC
957	Other O.R. Procedures for Multiple Significant Trauma with MCC

Showing 1–10 of 12

Typical Clinical Scenarios

Planned elective peripheral nerve reconstruction for a patient with isolated unilateral trapezius paralysis after prior radical neck dissection resulting in loss of accessory nerve function. The surgical team transfers a viable segment of the accessory nerve to reinnervate the spinal accessory distribution of the affected side to restore shoulder elevation and scapular stabilization. The procedure is scheduled as an inpatient elective neurotologic reconstruction using an open approach. Typical codes: 00XR0ZR
Acute traumatic posterior cervical injury from penetrating neck trauma with partial disruption of the accessory nerve resulting in immediate profound trapezius weakness and shoulder droop. During the same inpatient operative session the surgeon mobilizes and transfers a portion of the accessory nerve to reestablish continuity and assume function of the injured cranial nerve branch via an open surgical transfer to restore motor function. Typical codes: 00XR0ZR
Revision procedure for failed prior nerve repair with persistent denervation of shoulder musculature and synkinesis after initial reconstruction; surgeon performs a secondary transfer of accessory nerve fibers to the facial nerve region to improve motor control of neck and shoulder movements and to address functional deficits. The operation is performed inpatient and uses a percutaneous endoscopic approach to mobilize and re-route the accessory nerve to the target cranial nerve. Typical codes: 00XR4ZM

Related Codes

00XF-OLFACTORY-NERVE-TRANSFER

ICD-10-PCS Code for Olfactory Nerve: Procedure Code Group Overview

00XG-OPTIC-NERVE-TRANSFER

ICD-10-PCS Code For Optic Nerve: Procedure Code Group Overview

00XH-OCULOMOTOR-NERVE-TRANSFER

ICD-10-PCS Code For Oculomotor Nerve: Procedure Code Group Overview

00XJ-TROCHLEAR-NERVE-TRANSFER

ICD-10-PCS Code For Trochlear Nerve: Procedure Code Group Overview

00XK-TRIGEMINAL-NERVE-TRANSFER

ICD-10-PCS Code For Trigeminal Nerve: Procedure Code Group Overview

00XL-ABDUCENS-NERVE-TRANSFER

ICD-10-PCS Code For Abducens Nerve: Procedure Code Group Overview

00XM-FACIAL-NERVE-MOVING-FACIAL-NERVE-TRANSFER

ICD-10-PCS Code For Facial Nerve: Procedure Code Group Overview

00XN-ACOUSTIC-NERVE-TRANSFER

ICD-10-PCS Code For Acoustic Nerve: Procedure Code Group Overview

00XP-GLOSSOPHARYNGEAL-NERVE-TRANSFER

ICD-10-PCS Code For Glossopharyngeal Nerve: Procedure Code Group Overview

00XQ-VAGUS-NERVE-TRANSFER

ICD-10-PCS Code For Vagus Nerve: Procedure Code Group Overview

Showing 1–10 of 11

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-PCS Code For Accessory Nerve: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Accessory Nerve: Procedure Code Group Overview policy alerts

Accessory Nerve Transfer Procedure Overview

Code Attributes

ICD-10-PCS Code For Accessory Nerve: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Accessory Nerve: Procedure Code Group Overview policy alerts

Accessory Nerve Transfer Procedure Overview

Code Attributes

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-PCS section and body system cover accessory nerve transfers?

What is the purpose of codes in the 00XR ICD-10-PCS group?

How are individual procedure codes in this group formatted and can you give examples?

Which DRG categories may be assigned when coding accessory nerve transfer procedures?

Why is accurate coding of accessory nerve transfers important for inpatient reimbursement?

References

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-PCS section and body system cover accessory nerve transfers?

What is the purpose of codes in the 00XR ICD-10-PCS group?

How are individual procedure codes in this group formatted and can you give examples?

Which DRG categories may be assigned when coding accessory nerve transfer procedures?

Why is accurate coding of accessory nerve transfers important for inpatient reimbursement?

References