Summary & Overview
CPT 64719: Open Ulnar Nerve Decompression at Wrist
CPT code 64719 defines an open surgical decompression that incises scar tissue or other compressive elements to relieve pressure on the ulnar nerve at the wrist. This code captures a focused operative intervention addressing ulnar neuropathy at the wrist level, a condition that affects hand sensation and motor function and can lead to impaired grip and dexterity. Nationally, accurate coding of this procedure matters for clinical documentation, payment integrity, and quality tracking for peripheral nerve surgeries.
Key payers commonly involved in coverage and reimbursement for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical purpose of the code, typical sites of service, and common billing considerations. The publication provides benchmarks and policy-relevant insights where available, clarifies service definitions for coding and claims processing, and summarizes clinical context relevant to coding decisions. Data not available in the input will be noted accordingly.
Billing Code Overview
CPT code 64719 describes an open surgical procedure to incise scar tissue or other compressive structures to relieve pressure on the ulnar nerve at the wrist. The operation targets the ulnar nerve, a major peripheral nerve that supplies sensation and motor function to portions of the arm, forearm, hand, and the little and ring fingers.
Service Type: Open surgical decompression of the ulnar nerve at the wrist
Typical Site of Service: Hospital outpatient department or ambulatory surgery center; may also be performed in an inpatient operating room when clinically indicated
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old manual laborer presenting with progressive numbness and tingling in the small and ring fingers, hand weakness, and intermittent ulnar-sided wrist pain despite conservative care (activity modification, splinting, NSAIDs, and sometimes corticosteroid injection). Examination shows decreased sensation in the ulnar nerve distribution, weakness of intrinsic hand muscles, and positive provocative tests for ulnar nerve compression at the wrist (e.g., positive Tinel sign over Guyon’s canal). Electrodiagnostic testing (EMG/NCS) may confirm ulnar neuropathy at the wrist. When symptoms persist or there is motor deficit or progressive electrodiagnostic abnormality, the surgeon schedules an open release of ulnar nerve decompression at the wrist (CPT 64719).
The clinical workflow includes preoperative evaluation and informed consent, perioperative anesthesia (local/regional block or general), open incision and neurolysis of the ulnar nerve with release of compressive structures (scar tissue, ganglion, fibrous bands) at Guyon’s canal, hemostasis and layered closure, and brief postoperative recovery with wound care and hand therapy as indicated. Typical sites of service are ambulatory surgery centers or hospital outpatient operating rooms. Postoperative documentation includes operative note with laterality, intraoperative findings, estimated blood loss, and specific maneuvers performed, plus a plan for follow-up and rehabilitation.
Coding Specifications
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