01XB0ZC
Transfer Lumbar Nerve to Perineal 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 | B Lumbar Nerve |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | C Perineal 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
Lumbar Nerve
Lumbar nerve transfer involves using a lumbar spinal nerve root or its branches, structures that contribute to the lumbosacral plexus supplying the lower limb, as either donor or recipient tissue when reconstructing function after lumbosacral plexus injury, pelvic trauma, or tumor resection. These nerves lie deep within the retroperitoneum alongside major vascular structures, making surgical access more complex than for extremity nerves and often requiring a combined approach with vascular or general surgery. A common application is transferring a portion of a functioning lumbar root to reinnervate the femoral nerve to restore knee extension. Given the depth and proximity to critical structures, documentation should identify the specific lumbar level and its role as donor or recipient in the transfer procedure.
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: Perineal Nerve
The Perineal Nerve, a terminal branch of the pudendal nerve, supplies sensory and motor innervation to the perineum, including the external genitalia and pelvic floor musculature. As a qualifier it identifies this nerve specifically, distinguishing it from other lower-limb and pelvic nerves such as the femoral or sciatic nerve, which serve larger, more proximal territories.
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.