Transection of 12 facial nerve branches

[sutherngyrl]

What CPT code would you use?

The procedure involves a tedious complete dissection of all facial nerve branches (12-20 usually), then branches are stimulated electrically to observe the facial movement each branch produces and several branches are cut to reduce the function of those select branches.

 

[b.cobuzzi]

I would feel more comfortable coding if I read the whole op note. But here is my attempt to try.

All I can find is 64742 - Transection or avulsion of; facial nerve, differential or complete
Lay Description:
In this procedure, the provider transects or forcibly tears the facial nerve or any branch of the facial nerve to give relief from facial pain by diminishing the sensation.

Clinical Responsibility
When the patient is appropriately prepped and anesthetized, the provider makes an incision just behind the ear, also called a post–auricular incision. Next the provider locates the facial nerve and either he cuts the nerve with a sharp object or forcibly separates it from its point of emergence. The provider can perform the procedure on the main facial nerve, or he can extend the incision downward to cut or avulse a branch of the facial nerve causing the problem. After the procedure, the provider closes the incision with sutures.

That refers to one nerve and Medicare MUE (Max Units Expected) is 1. So, if this is the code, you can bill it with a 22 modifier and increase the fee and put in Box 19 of the claim, the number of nerve branches dissected.