Patient comes in through the emergency room with a wound that was caused by an electric saw. Patient is taken to the operating room where two ulna nerves are sutured.

The procedure described is the suture of two ulnar nerves. In the CPT codebook, the section for "Suture of Nerve (Neurorrhaphy)" provides specific codes for this procedure. CPT code 64836, "Suture of one nerve, hand or foot; ulnar motor," is the correct code for the primary procedure on the first nerve. Because a second ulnar nerve was also repaired during the same operative session, the add-on code 64837, "Suture of each additional nerve, hand or foot," must also be reported. This combination accurately reflects the repair of two distinct nerves.

A. 64837: This is an add-on code and cannot be reported by itself; it must accompany a primary procedure code.
B. 64892; 69990: Code 64892 describes a nerve graft, which is a different procedure from a direct suture. Code 69990 is for microsurgery, which was not documented.
D. 64856; 64859: These codes are for major peripheral nerves of the "arm or leg" and are less specific than 64836, which precisely identifies the ulnar motor nerve in the hand.

1. American Medical Association. (2023). CPT® 2024 Professional Edition. Chicago

IL: AMA.

Page/Section: Nervous System

Surgery; Codes 64836

64837. The code descriptions specify "Suture of one nerve

hand or foot; ulnar motor" for 64836 and the parenthetical note for 64837 indicates it is an add-on code for each additional nerve.

2. Bowie

M. J. (2022). Understanding Current Procedural Terminology and HCPCS Coding Systems

2023 Edition. Cengage Learning.

Chapter 16: Nervous System: This chapter explains the hierarchy of nerve repair codes

emphasizing the use of the most specific code available and the correct application of primary and add-on codes for multiple nerve repairs in the same anatomical area.

3. AHIMA. (2022). Clinical Coding Workout: Practice Exercises for Skill Development. Chicago

IL: AHIMA Press.

Section: Nervous System Coding Scenarios. This resource provides examples and rationales that reinforce the principle of selecting the most precise CPT code and using add-on codes for additional

distinct procedures performed during the same session.