Need help choosing the right code?
Ask CasePilot about procedures, modifiers, bundling, and coding guidance.
Try CasePilot© Copyright 2026 American Medical Association. All rights reserved.
The CPT® Code 64866 refers to the surgical procedure known as facial-spinal accessory nerve anastomosis, which is a reconstructive technique aimed at restoring function to the facial nerve. This procedure is typically indicated for patients who have suffered facial nerve damage, often due to trauma, surgical complications, or other medical conditions that impair facial nerve function. The anastomosis involves connecting the facial nerve to the spinal accessory nerve, which is responsible for certain motor functions in the neck and shoulder region. The surgical approach begins with an incision made in front of the ear, allowing access to the parotid gland and surrounding structures. The procedure requires careful dissection to identify the facial nerve as it exits the skull and to prepare the spinal accessory nerve for connection. By utilizing microsurgical techniques, the surgeon ensures that the anastomosis is performed with precision, aiming to restore facial movement and improve the patient's quality of life. This complex procedure underscores the intricate relationship between the facial and spinal accessory nerves and highlights the importance of surgical skill in achieving successful outcomes in nerve reconstruction.
© Copyright 2026 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 64866 is indicated for the following conditions:
The surgical procedure for CPT® Code 64866 involves several critical steps to ensure successful anastomosis of the facial and spinal accessory nerves:
After the completion of the facial-spinal accessory nerve anastomosis, patients typically require careful monitoring and follow-up care. Post-procedure care may include pain management, wound care, and monitoring for any signs of complications such as infection or nerve dysfunction. Patients are often advised on rehabilitation strategies to facilitate recovery and improve facial function. The expected recovery period can vary, and patients may need to engage in physical therapy to optimize outcomes and regain facial movement. Regular follow-up appointments are essential to assess the healing process and the effectiveness of the nerve reconstruction.
| Short Descr | FUSION OF FACIAL/OTHER NERVE | Medium Descr | ANASTOMOSIS FACIAL-SPINAL ACCESSORY | Long Descr | Anastomosis; facial-spinal accessory | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
This is a primary code that can be used with these additional add-on codes.
| 69990 | Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.