HCPCS C9352: Microporous Collagen Nerve Guide, Per cm

HCPCS Level II code C9352 represents a microporous collagen implantable tube (neuragen nerve guide), billed per centimeter of device length. This code captures a specialized implant used in peripheral nerve repair surgeries to bridge nerve gaps and facilitate axonal regeneration. As an implantable device code, C9352 matters nationally because it affects device coverage, surgical supply reimbursement, and access to advanced nerve repair technologies.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coverage considerations across major national payers, common clinical contexts for use, and benchmarking information where available. The publication outlines typical sites of service and the procedural setting in which the device is applied.

The report provides practical reference material for billing staff and policy analysts: definitions and clinical context for the code, payer coverage patterns, documentation essentials, and how this implantable device is typically reported on the claim line. Data not available in the input is noted where applicable. The content is intended for a national audience of hospital administrators, surgical providers, and revenue cycle professionals seeking clarity on coding and payer engagement for nerve guide implants.

Billing Code Overview

HCPCS Level II code C9352 describes a microporous collagen implantable tube (neuragen nerve guide), per centimeter length. This item is a medical implant designed to support peripheral nerve repair by providing a collagen-based conduit to guide axonal regrowth across nerve gaps.

Service type: Implantable medical device for peripheral nerve repair
Typical site of service: Surgical settings such as hospital operating rooms or ambulatory surgery centers where nerve repair procedures are performed

Clinical Context

A patient presents with a symptomatic peripheral nerve injury (commonly digital nerve transection or neuroma) after a traumatic laceration to the hand. Following clinical evaluation and electrodiagnostic testing as indicated, the surgeon plans an open operative repair with placement of a microporous collagen implantable nerve guide for nerve gap reconstruction. The procedure is performed in an ambulatory surgery center or hospital operating room under regional or general anesthesia with sterile exposure of the injured nerve, debridement of devitalized tissue, measurement of the nerve gap in centimeters, and insertion of the C9352 microporous collagen implantable tube (neuragen nerve guide) sized to span the gap. Hemostasis is achieved, soft tissues are closed, and a dressing and immobilization are applied. Postoperative workflow includes routine recovery monitoring, wound checks, pain control, hand therapy for mobilization and sensory re-education, and scheduled follow-up visits to assess nerve regeneration and functional recovery. Typical sites of service include ambulatory surgery centers, hospital outpatient departments, and inpatient operating rooms when performed with concurrent procedures or complex trauma care.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to implant the nerve guide is substantially greater than usual (extensive scar, complex exposure).

Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopedic Surgery	Commonly performs peripheral nerve repair in extremity trauma.
`2080P0003X`	Plastic Surgery	Performs delicate soft tissue and peripheral nerve reconstructions in the hand and face.
`2084P0800X`	Neurosurgery	Performs peripheral nerve and complex nerve gap reconstructions, especially proximal injuries.
`2085R0200X`	General Surgery	May perform peripheral nerve repairs in trauma settings, particularly in community hospitals.
`363A00000X`	Physician Assistant	Frequently assists in perioperative care and may perform aspects of care depending on state law and payor policy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S64.011A`	Nondisplaced traumatic amputation of right index finger at metacarpophalangeal joint, initial encounter	Represents a traumatic finger injury with nerve involvement where a nerve guide may be used for reconstruction.
`S64.012A`	Nondisplaced traumatic amputation of left index finger at metacarpophalangeal joint, initial encounter	Similar traumatic scenario on the contralateral side requiring nerve repair.
`S64.021A`	Injury of digital nerve of right index finger, initial encounter	Direct digital nerve injury commonly treated with nerve conduits for gap repair.
`S64.022A`	Injury of digital nerve of left index finger, initial encounter	Left-sided digital nerve injury; indicates clinical need for nerve reconstruction.
`S64.031A`	Laceration without foreign body of right wrist, initial encounter	Peripheral nerve lacerations at the wrist may require nerve graft or conduit placement.
`G56.0`	Carpal tunnel syndrome	Chronic compressive neuropathy where nerve conduits are occasionally used in revision or complex reconstructions.
`M79.2`	Neuralgia and neuritis, unspecified	Symptomatic neuropathic pain or neuroma where surgical intervention with a nerve guide may be considered.
`T79.A11A`	Traumatic amputation of right shoulder and upper arm, initial encounter	Major traumatic upper extremity injury with potential nerve gaps requiring reconstructive conduits.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64831`	Excision of neuroma; major peripheral nerve, requiring repair	Performed when neuroma excision is required prior to placement of a nerve guide for gap reconstruction.
`64872`	Repair/transfer of peripheral nerve, single nerve, without grafting, with or without conduit, or neuroplasty	Used for primary nerve repair or repair using a conduit such as a collagen nerve guide when documented as the operative technique.
`69990`	Microsurgical techniques, requiring use of an operating microscope (list separately in addition to primary procedure)	Billed when microsurgical magnification is used during delicate nerve coaptation and conduit placement.
`12001`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (2.5 cm or less)	May be billed for soft-tissue skin closure adjacent to the nerve repair when applicable for superficial closures (select appropriate wound repair code by complexity and size).
`64718`	Neuroplasty and/or transposition; major peripheral nerve (e.g., median nerve at carpal tunnel)	Performed for extensive nerve decompression or neurolysis which may be done in conjunction with nerve guide placement if indicated.

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Summary & Overview