Summary & Overview
CPT 64913: Nerve Tissue Graft, Each Additional Nerve Strand
CPT code 64913 covers the use of a donor-derived nerve tissue graft for peripheral nerve repair and represents billing for each additional nerve strand beyond the initial graft. This microsurgical procedure supports reconstruction of damaged nerves using cadaveric or living-donor nerve allografts or autografts and is relevant to specialty surgical practices and hospitals performing peripheral nerve reconstruction nationwide. Key commercial and public payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context, typical sites of service, and the role of additional-strand reporting in surgical documentation. The publication also outlines common modifiers used with this code, payer coverage considerations where available, and how 64913 relates to operative reporting and charge capture. Data not available in the input is noted where payer-specific policies, associated taxonomies, ICD-10 diagnoses, and related codes would normally be detailed.
Billing Code Overview
CPT code 64913 describes the use of a nerve tissue graft harvested from a cadaveric or living donor to repair a peripheral nerve. This code applies to each additional nerve strand grafted after the first strand during a nerve repair procedure.
Service Type: Surgical nerve grafting using donor nerve tissue.
Typical Site of Service: Hospital operating room, ambulatory surgery center, or other surgical suite providing microsurgical nerve repair.
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents after a crush injury to the forearm with loss of digital sensory and motor function. After clinical exam and electrodiagnostic testing confirming a segmental peripheral nerve defect of the median nerve, the surgical team plans nerve reconstruction. During surgery the gap is too large for tension-free direct repair; a nerve graft is required. The surgeon harvests or implants cadaveric/surrogate nerve allograft for the primary nerve strand and uses additional nerve strands to reconstruct the multi-fascicular defect. 64913 is reported for each additional graft strand beyond the first. Typical workflow includes preoperative evaluation, informed consent discussing graft source (autograft vs allograft), intraoperative nerve debridement and measurement of the gap, placement of the primary nerve graft strand, additional graft strands as needed (billed with 64913 per additional strand), microsurgical coaptation with sutures and/or fibrin glue, and postoperative wound care and rehabilitation with occupational therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when an additional nerve graft strand represents a separate anatomic site or distinct procedural service from other procedures on the same claim. |