Summary & Overview
CPT 64736: Mental Nerve Transection for Facial Pain
CPT code 64736 denotes a surgical transection of the mental nerve performed to relieve localized facial pain by diminishing sensation. The procedure addresses severe or refractory neuropathic pain in the mental nerve distribution and is relevant to surgical, pain management, and oral/maxillofacial practices. Nationally, this code matters for specialty surgical reimbursement, utilization monitoring for invasive pain treatments, and alignment with clinical practice patterns for facial neuropathic pain management.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for CPT code 64736, typical sites of service, common billing modifiers, and the payer landscape that affects coverage and payment considerations. The publication summarizes benchmark patterns where available, notes policy and coding guidance relevant to peripheral nerve procedures, and outlines clinical indications tied to facial neuropathic pain.
This summary equips billing managers, clinicians, and policy analysts with a concise reference to the procedure's clinical purpose, expected settings of care, and the major payers involved. Data not available in the input is identified where necessary to avoid inference beyond the provided information.
Billing Code Overview
CPT code 64736 describes a surgical procedure in which the provider transects or forcibly tears the mental nerve to relieve facial pain by diminishing sensation. This procedure is a form of peripheral nerve intervention intended to reduce chronic or severe neuropathic pain localized to the distribution of the mental nerve.
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Service type: Surgical peripheral nerve procedure
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Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old adult with chronic, intractable neuropathic pain localized to the distribution of the mental nerve following mandibular nerve injury or persistent idiopathic facial pain. Conservative measures (oral analgesics, anticonvulsants such as gabapentin or carbamazepine, local nerve blocks) and less invasive interventions have failed to provide durable relief. The patient undergoes a targeted neural interruption procedure in an ambulatory surgery center or hospital operating room under monitored anesthesia care or general anesthesia. The provider identifies the mental nerve at the mental foramen and performs a neurotomy by transecting or forcibly tearing the nerve to diminish sensory transmission and reduce pain. Typical workflow includes preoperative evaluation and informed consent, image review or ultrasound/nerve block localization, administration of anesthesia, sterile exposure of the mental nerve, surgical transection, hemostasis, wound closure, postoperative recovery, and narcotic-sparing pain management. Postoperative follow-up documents sensory changes, wound healing, and pain outcomes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Primary procedure | Use when this procedure is the primary service performed during the encounter. |
22 |