Summary & Overview
CPT 64795: Nerve Biopsy, Excision of Nerve Sample
CPT code 64795 represents a targeted surgical nerve biopsy in which a small segment of nerve is excised for laboratory examination. The procedure is clinically important for diagnosing peripheral nerve disorders such as axonal degeneration, demyelinating neuropathies, and inflammatory or immune-mediated neuropathies. As a focused diagnostic surgical service, it impacts clinical decision-making for neurologists, neurosurgeons, and peripheral nerve specialists nationwide.
Key national payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment policies for nerve biopsy procedures vary by payer and influence site-of-service selection, preauthorization requirements, and documentation expectations.
Readers will find a concise overview of the code’s clinical context, typical sites of service, and the payer landscape. The publication summarizes common billing considerations, typical modifiers and their roles (list provided separately), and where to find supporting documentation and clinical indications for the procedure. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 64795 describes the surgical excision or removal of a small sample of a nerve for laboratory examination. The procedure is performed to obtain tissue for histopathologic evaluation to diagnose nerve damage, degeneration, or inflammatory neuropathies.
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Service type: Surgical diagnostic procedure (nerve biopsy)
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Typical site of service: Hospital operating room, ambulatory surgery center, or specialty clinic procedure room
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old adult referred to a peripheral nerve surgeon or neurosurgeon for progressive numbness, paresthesia, and focal weakness in a limb after trauma or with suspected neuropathy. Prior evaluation includes a history and physical, electromyography/nerve conduction studies showing abnormalities, and imaging when indicated. The provider obtains informed consent for surgical nerve biopsy to obtain a small segment of a peripheral sensory nerve (commonly sural nerve) for histopathology, special stains, and possible immunohistochemistry to evaluate for demyelination, axonal degeneration, vasculitis, amyloid, or inflammatory neuropathies.
The clinical workflow: preoperative assessment and optimization, marking the biopsy site (often sural nerve in the posterior-lateral calf for sensory testing), administration of local or general anesthesia, aseptic exposure of the nerve, excision of the required small segment with preservation of proximal and distal continuity where possible, hemostasis, specimen labeling and submission to pathology with relevant clinical history, closure of the incision, and postoperative follow-up for wound care and review of pathology results that inform diagnosis and further medical management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normally consistent performance of the service | Use when the procedure was performed without any unusual problems and is the usual performance of the provider. |