CPT code 64746 denotes surgical severing or removal of part of the phrenic nerve to produce unilateral diaphragmatic paralysis. Clinically, the procedure is employed to collapse a diseased lung during extended thoracic operations or to address a damaged or diseased phrenic nerve via resection or repair. The code captures a specialized operative thoracic/nerve surgery with implications for perioperative respiratory management and postoperative rehabilitation.

This national overview covers coverage and payment considerations across major payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical intent and typical care setting, plus what to expect in payer coverage patterns and billing practice for complex thoracic nerve procedures. The publication summarizes common billing modifiers and related administrative notes, outlines typical sites of service, and highlights clinical context relevant to coding and claims submission. It also identifies gaps where input data is not available.

Intended readers include coding professionals, surgical and thoracic practice administrators, and policy analysts seeking a clear, national-level briefing on the use and administrative handling of CPT code 64746 in operative care.