01X60Z4
Transfer Radial Nerve to Ulnar 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 | 6 Radial Nerve |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | 4 Ulnar 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
Radial Nerve
Radial nerve transfer redirects fascicles or branches of this predominantly motor extensor nerve, commonly a triceps branch, to reinnervate targets like the axillary nerve for shoulder abduction or, in reverse, to receive innervation when its own distal branches to wrist and finger extensors have been injured. The radial nerve travels through the spiral groove of the humerus and is vulnerable to injury from fractures at that level, which can leave functioning proximal fascicles available as donors even when distal segments are disrupted. Selecting a triceps or other expendable branch preserves elbow extension while providing axons for a more functionally critical deficit elsewhere. As with other upper extremity transfers, the coded body part reflects the specific radial nerve segment used, and outcomes hinge on the distance the regenerating axons must travel to the new target.
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: Ulnar Nerve
The Ulnar Nerve runs along the medial forearm and hand, supplying most intrinsic hand muscles and sensation to the little finger and part of the ring finger; it is the nerve responsible for the "funny bone" sensation at the elbow. As a qualifier it distinguishes this nerve from the median and radial nerves, its companions in the upper extremity, when specifying the target of a procedure.
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.