01XD0ZH
Transfer Femoral Nerve to Peroneal Nerve with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | 1 Peripheral Nervous System |
| Operation | X Transfer |
| Body Part | D Femoral Nerve |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | H Peroneal Nerve |
Operation Definition
Moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion of a body part
Procedure Overview
Transfer procedures on the peripheral nervous system move a nerve, still attached to its original blood and nerve supply at one end, to a new location so it can take over the function of a different, nonworking nerve. Nerve transfers are used after severe injuries, such as brachial plexus avulsions, when the original nerve supplying a muscle is damaged beyond repair but a healthy, less critical nerve nearby can be redirected to reinnervate that muscle instead. A common example is transferring a branch of the spinal accessory nerve to the suprascapular nerve to restore shoulder function after a brachial plexus injury.
Because the donor nerve is not cut free entirely but repositioned to connect with a different target, these procedures differ from a graft, which uses a separate, disconnected piece of tissue to bridge a gap. Transfer is chosen specifically when restoring the original damaged nerve directly is not feasible.
Anatomy & Axis Detail
Femoral Nerve
Femoral nerve transfer involves this large nerve of the anterior thigh, which supplies the quadriceps and is essential for knee extension and ambulation, functioning either as a donor of an expendable branch or, more frequently, as the recipient of transferred fibers from an adjacent lumbar or obturator source after lumbosacral plexus injury. The femoral nerve emerges beneath the inguinal ligament and divides quickly into multiple branches serving individual quadriceps heads and cutaneous territory, giving surgeons some flexibility in fascicle selection while requiring preservation of the branches most critical to knee stability. Restoring femoral nerve function is a priority in lower limb reconstruction because loss of active knee extension severely limits independent walking. Documentation should note whether the femoral nerve was the donor or recipient tissue.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Qualifier: Peroneal Nerve
The Peroneal Nerve, the other terminal branch of the sciatic nerve, courses around the fibular head to supply the muscles of dorsiflexion and eversion, and is particularly susceptible to compression injury causing foot drop. As a qualifier it distinguishes this nerve from the tibial nerve, its sciatic-derived counterpart on the posterior leg.
Coding & Documentation
The operative note needs to name both the donor nerve being moved and the recipient nerve or muscle it is being connected to, since the body part value coded reflects the nerve being transferred, not the target. A frequent coding error is mistaking a nerve transfer for a nerve graft repair; the distinguishing detail is whether the donor nerve retains its native blood supply and proximal attachment (Transfer) or is a free segment used to bridge a gap in a different nerve (Repair or Replacement). Coders should also check whether the transferred nerve is being coapted directly to the recipient nerve or routed through a graft, which can mean an additional code is warranted.