CPT® Code 64864

The procedure described by CPT® Code 64864 involves the surgical suture of the extracranial portion of the facial nerve, which is also known as cranial nerve VII (CN VII). This nerve is primarily responsible for facial expression and contains both somatosensory and secretomotor fibers. The extracranial segment of the facial nerve begins at the stylomastoid foramen, where it exits the skull. Once outside the skull, the facial nerve branches into several rami and divides into its main branches, which are essential for various facial functions. During the procedure, the surgeon exposes and explores the extracranial facial nerve to assess the extent of any injury. If damage is identified, the affected tissue is debrided to prepare for repair. Intraoperative nerve function testing and monitoring may be performed as necessary to ensure proper nerve function is maintained. The repair of the nerve ends is accomplished using sutures, which may involve a microscopic technique if required. The surgical approach can vary, with options including epineural repair, where sutures are placed in the epineurium of the nerve ends, or perineural closure, which involves suturing individual fascicles of axons together. The goal of the procedure is to achieve end-to-end closure of the nerve while avoiding tension on the sutures. Following the nerve repair, the overlying soft tissues and skin are meticulously repaired in layers to promote optimal healing.