01QD4ZZ
Repair Femoral Nerve to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 1 Peripheral Nervous System |
| Operation | Q Repair |
| Body Part | D Femoral Nerve |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Restoring, to the extent possible, a body part to its normal anatomic structure and function
Procedure Overview
This family covers restoring a peripheral nerve to as close to its normal structure and function as possible after it has been cut, torn, or otherwise physically damaged, using suture repair or direct approximation of the nerve ends. It is the primary approach when a nerve laceration is found from a knife wound, glass injury, iatrogenic surgical injury, or a fracture that has sheared through the nerve.
The surgeon aligns the cut nerve ends under magnification, matching the internal fascicles as precisely as possible, and sutures them together so the nerve can regenerate along its original pathway. Timing matters clinically, since nerves repaired soon after injury generally recover better than those repaired after prolonged delay, though repair can still be attempted later in appropriate cases.
Outcomes depend on the nerve involved, the distance the injury is from the muscles or skin it serves, and how cleanly the nerve ends can be matched, but the goal is always to reestablish continuity using the patient's own nerve tissue.
Anatomy & Axis Detail
Femoral Nerve
The femoral nerve is the largest branch of the lumbar plexus, descending through the pelvis beneath the inguinal ligament to innervate the quadriceps and supply sensation to the anterior thigh and medial leg. It is at risk during pelvic and hip surgery, retroperitoneal procedures, or penetrating groin trauma, and injury characteristically produces difficulty with knee extension and loss of the patellar reflex. Repair is indicated when the nerve is lacerated or compressed, and because it runs alongside the femoral artery and vein in the femoral triangle, the surgeon must carefully isolate the nerve from these vessels before performing direct suture or graft repair. The proximity to major vessels makes precise documentation of the surgical field and any concurrent vascular involvement clinically relevant.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Coding & Documentation
Documentation supporting this code should describe direct suture of nerve ends or another technique that reconnects the nerve's own tissue without adding graft material. The note should identify which specific nerve was repaired and the mechanism of injury, since that context often appears in related trauma documentation.
A common mistake is assigning Repair when the surgeon actually bridged a gap with a nerve graft or synthetic conduit, which belongs under Replacement or Supplement instead of Repair. Another frequent error is coding Repair for a procedure that was really a Release, when the nerve was found intact and simply freed from surrounding scar rather than physically damaged and sutured.