CPT® Code 64802

The sympathetic nervous system is a critical component of the autonomic nervous system, responsible for regulating involuntary bodily functions such as sweating, blushing, and salivation. A sympathectomy is a surgical procedure that involves the destruction or excision of sympathetic nerve fibers to alleviate certain medical conditions. Specifically, CPT® Code 64802 refers to a cervical sympathectomy, which is typically performed to enhance blood flow in the internal carotid arteries. This procedure is distinct from a cervicothoracic sympathectomy, which is coded under CPT® Code 64804. During a cervical sympathectomy, an incision is made in the neck to access the sympathetic chain, allowing for the division or removal of nerve fibers. The surgical approach may involve dissection of surrounding tissues, and in some cases, the lung may be deflated to improve visibility of thoracic structures. The sympathetic chain is then cut using electrocautery, or a segment may be excised entirely. The procedure aims to obliterate the ganglia, effectively severing the sympathetic chain to address various conditions, including hyperhidrosis, thoracic outlet syndrome, reflex sympathetic dystrophy, and chronic pancreatic pain. The specific level at which the sympathetic chain is transected depends on the underlying condition being treated, with different levels targeted for different symptoms. Following the completion of the procedure, the lungs are re-expanded, a chest tube may be placed, and the incision is closed to facilitate recovery.