Wiki Internal neurolysis with possible loupe

[tobeornottobeacoder]

I have a doctor that performed a internal neurolysis in the attempt to preserve the nerves that encompassed a lymph node he was trying to excise. The doctor is trying to bill for CPT 64722 for the decompression and add on code CPT 64727 for the internal neurolysis. My question is 64727 requires a operating microscope and he did not note in the op notes that a operating microscope was used. We are querying the doctor to see if possibly he used a loupe (magnifer) instead. If the loupe was used, would this still be considered a operating microscope and justify the usage of 64727??

Any suggestions??