CPT® Code 64885

A nerve graft procedure involves the surgical repair of a damaged nerve in the head or neck using a graft taken from another nerve. This technique is employed to facilitate a tension-free repair of the injured nerve, which is crucial for restoring proper nerve function. During the procedure, the surgeon first exposes the injured nerve and assesses the extent of the damage. Any necrotic or damaged tissue is debrided to prepare the site for grafting. To evaluate nerve function, additional nerve testing and monitoring may be performed, which are reported separately. The healthy segments of the nerve, both proximal and distal to the injury, are carefully dissected to free them from surrounding tissues, allowing for accurate measurement of the required graft length. Once the appropriate length is determined, the nerve graft is harvested from a donor site, which involves exposing the donor nerve and dissecting it free from surrounding tissue. The graft is then cut at both ends to prepare it for attachment. The next step involves suturing the graft to the ends of the severed nerve. This can be accomplished through various techniques, including end-to-end anastomosis. In an epineural repair, sutures are placed in the outer layer of the nerve (epineurium) at one end of the severed nerve and the graft, followed by securing the sutures to approximate the two ends. The same technique is applied to the other end of the injured nerve. Alternatively, a perineural closure technique may be utilized, where the epineurium is retracted to expose the individual fascicles of axons. These fascicles, which are responsible for specific functions such as sensory or motor activities, are identified and sutured together. The closure process is meticulous, starting with the deeper fascicles and progressing toward the surface, ensuring that all nerve structures are properly repaired. Finally, the overlying soft tissues and skin are sutured in layers to complete the procedure. This code, 64885, is specifically used when the nerve graft is 4 cm or less in length, while 64886 is designated for grafts exceeding this length.