triceps tendon repair cpt code

Updated: 4/20/2020. Note that CPT code 20103 is defined as a separate procedure code; thus, the maneuvers are included in code 20103 and are not separately reportable. In a click, check the DRG's IPPS allowable, length of stay, and more. One patient in particular is being seen under a workers compensation claim and had a surgical procedure Orthopedic doctor was to perform procedure 24342- Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft, but provider now wants to bill an exploratory cpt code. Shoulder360 The Comprehensive Shoulder Course 2023, Type in at least one full word to see suggestions list. SomeAAOS Nowarticles are available only to AAOS members. Current Procedural Terminology (CPT) includes references to specific locations in the forearm, wrist, hand, and fingers for reporting flexor and extensor tendon repair codes. When it is performed in conjunction with other hand procedures, it cannot be assumed that the service is medically necessary. triceps tendon repair cpt code M66.822 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. You are using an out of date browser. Patellar Tendon Repair CPT Code (OBQ10.107) [QUOTE]The arm was prepped and draped. Bridge plating of the olecranon is MOST appropriate in which of the following clinical scenarios? Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. Tendon / Muscle Repair CPT Codes - Proximal to hand Repair, tendon or muscle, upper arm or elbow, each (24341) Reinsertion of ruptured biceps tendon, distal, with or without tendon graft (includes obtaining graft) (24342) Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle (25260) ICD 10 code for Spontaneous rupture of other tendons, left upper arm. Per CPT: Dbridement is considered a separate procedure only when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when dbridement is carried out separately without immediate primary closure. For example, separate reporting of dbridement from the 1104211047 series of CPT codes would not be allowed in conjunction with an open wound with a tendon laceration, unless the criteria above are met and well documented in the operative report. If intra-articular, the operative note must specify the number of fragments (one to two or three or more). To report this scenario correctly, append modifier 51 to CPT code 25270 to indicate multiple procedures performed during the same surgical setting (Fig. ICD 10 code for Spontaneous rupture of other tendons, right upper arm. Clear documentation in the operative record of indications for nerve service is mandatory. Only traumatic triceps tendon tears were included with a minimum follow up of 2 . You Be the Coder: Pinpoint Triceps Repair Code Options Here, Pinpoint Triceps Repair Code Options Here. One of our orthos tried to do an open repair, but when they opened the patient, the surgeon couldn't find the tendon. Open reduction and internal fixation with k-wires, Open reduction and internal fixation with tension band wiring, Open reduction and internal fixation with plate fixation, Open reduction and internal fixation with an intramedullary screw. Capsular shift/capsulorrhaphy for multidirectional instability, Reconstruction of complete shoulder [rotator] cuff avulsion, chronic Acceptable CPT codes for Orthopaedic Sports Medicine Subspecialty Case List . (OBQ10.38) (SBQ12TR.11) registered for member area and forum access. You must log in or register to reply here. (OBQ05.266) Orthopedic surgeons always repair triceps distally. For clinical responsibility, terminology, tips and additional info start codify free trial. The provider has coded 24342, but I don't see that an actual reinsertion was performed. When transection or resection of the anterior interosseous nerve (AIN) or posterior interosseous nerve (PIN) is performed, be sure to include an appropriate supporting pain diagnosis. I was looking towards the 24342 for tricep repair with icd-9 841.8, and 24147 with icd-9 813.01 for excised bony fragment of the olecronon. Its proven that a diagnosis of heart disease or ex Healthcare business professionals from around the world came together at REVCON a virtual conference by AAPC Feb. 78 to learn how to optimize their healthcare revenue cycle from experts in the field. Diagnosis can be made clinically with the inability to extend the elbow against resistance. This code specifies the reinsertion of ruptured biceps or triceps, distal end. Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. Key Words: triceps rupture, suture anchor, triceps repair, elbow surgery (Tech Hand Surg 2018;22: 89-93) T riceps tendon rupture is an uncommon yet potentially Copyright 2023 Lineage Medical, Inc. All rights reserved. of shoulders, please visit When PAs serve as first assistants during [], Some Worker's Comp Insurers May Opt out of ICD-10, CMS Says, But Medicare and Medicaid plans will not give you an extension past Oct. 1, 2014, [], Question: How should I code a triceps repair? Patient having repair of distal biceps tendon rupture, CPT 24342 Request a Demo 14 Day Free Trial Buy Now Get free rules, notes, crosswalks, synonyms, history for ICD-10 code S46.312A. (OBQ11.141) (OBQ05.181) Moreover, application of the initial splint or cast is part of the surgical dressing and is not separately reportable. When CPT code 20103 is supported, we often find that surgeons also code for dbridement from the 1104X series of codes, or nerve neurolysis (647XX) for nerve explorations. A radiograph is provided in Figure A. 25275 Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes . Billing for hand procedures is among the most complex types of orthopaedic coding. If [], PA Assisting at Surgery? Other Articles in this issue of Orthopedic Coding Alert Knee: Treatment is either immobilization or primary repair depending on patient age, patient underlying systemic disease, chronicity of injury and patient activity demands. The fracture reduction codes include the use of fluoroscopy to assess fracture reduction; CPT code 76000 is not separately reportable. It also is considered unbundling to report codes 14040 and 1313X in addition to code 26952 for amputation closure with flap (e.g., VY). Per Medicare Fee Schedule, CPT 24342 has a surgical assistant payment indicator of 2, which means, "Payment restriction f Our physicians assistant works side by side with one of our MDs during every surgical procedure. Triceps repair is a surgical procedure that involves the repair of a ruptured (torn) triceps tendon. I have a provider that performed an Arthrotomy on the elbow along with repairing a triceps defect. The operative note must contain clinical justification and clear documentation of techniques, such as z-lengthening of the flexor pronator mass or lengthening of the flexor pronator fascia, in addition to dissection of the muscle and/or fascia, placement of the ulnar nerve in a submuscular location, and resuturing of the muscle. To plug inpatient facility revenue drains, subscribe to, Crosswalk to an anesthesia code and its base units, and calculate payments in a snap! Current Procedural Terminology (CPT) includes references to specific locations in the forearm, wrist, hand, and fingers for reporting flexor and extensor tendon repair codes. How will my [], Chondroplasties Are Inclusive to Meniscectomies, Question: What percentage of the meniscus must the surgeon remove before we should bill the [], Question: If the surgeon fuses vertebrae L1 through L3, should I report 22612, 22614; or [], Copyright 2023. Radiographs are shown in Figures A and B. How should I code a triceps repair? His radiographs show a comminuted displaced olecranon fracture involving 25% of the articular surface with global osteopenia. Triceps tendon tears are rare and can occur when there is a forced bend to a straight elbow, such as a fall onto an outstretched hand. Nontraumatic tear of left triceps tendon; Nontraumatic tear of left upper arm tendon; ICD-10-CM M66.822 is grouped within Diagnostic Related Group(s) (MS-DRG v 40.0): Under AAOS guidelines, 24342 includes arthrotomy which, in some instances, includes removal of bone or cartilage fragments. AAOS Now / The physician must clearly describe the flap (e.g., incisions made, nature of flap). This code specifies the reinsertion of ruptured biceps or triceps, distal end. If you are looking for medical information about the treatment American Hospital Association ("AHA"), Assistant Surgeon Reimbursement for CPT 24342, Exploration of proximal left forearm vasculature for orthopedic dr, Distal Biceps Repair with Tenodesis Brachialis, Distal biceps repair to the fascia of the brachialis bicep repair, Reconstruction distal biceps with Achilles allograft, Jury Convicts Physician for Misappropriating $250K From COVID-19 Relief, REVCON Wrap-up: Mastering the Revenue Cycle, OIG Audit Prompts ASPR to Improve Its Oversight of HPP, Check Out All the New Codes for Reporting Services and Supplies to Medicare. Copyright 2023 Lineage Medical, Inc. All rights reserved. Codes are selected based on the . Get free rules, notes, crosswalks, synonyms, history for ICD-10 code M66.821. triceps 24340 Tenodesis of biceps tendon at elbow (separate procedure) 24341 Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary . ), but such exploration is included in the structure repair codes. (OBQ11.135) An 82-year-old nursing home resident falls onto his elbow while rising from a seated position. This policy does not take precedence over CCI edits. Wondering if I need to code the Tenodesis Brachialis separately? The CPT code used for this procedure is 28200. If a second carpal bone is fully or partially excised, use of CPT code 25210 also is supported, but the code must be appended with modifier 59 to explain that the provider is not using it to report the first carpectomy, thus unbundling the arthroplasty service. Location specificity also is essential in fracture management reporting. The COVID19 pandemic and nationwide shutdown that started in March 2020 placed a spotlight on crisis preparedness within the U.S. hea Dont assume the codes youve been using to report drugs and biologicals still apply. Posterior Tibial Tendon Repair CPT Code Posterior tibial tendon connects the posterior tibialis muscle to the calf bone on the back side. Another code possibility is 24341 (Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary [excludes rotator cuff]). Distal Triceps Repair - Shoulder & Elbow - Orthobullets. If the physician performs tendon lengthening as a component of the submuscular transposition, a secondary CPT code may be reportable: 24305, Tendon lengthening, upper arm or elbow, each tendon. (OBQ09.192) A 62-year-old man falls on his porch and sustains an elbow injury. Nontraumatic tear of right triceps tendon; Nontraumatic tear of right upper arm tendon; ICD-10-CM M66.821 is grouped within Diagnostic Related Group(s) (MS-DRG v 40.0): Or lateral CPT 24358 - tenotomy elbow, , lateral or medial, debridement soft tissue or bone, with tendon repair or American Academy of Professional Coders debride soft tissue +/bone reattachment Session 1A, 10-11:30 "American Academy of Orthopaedic Surgeons" and its associated seal and "American Association of Orthopaedic Surgeons" and its logo are all registered U.S. trademarks and may not be used without written permission. Whether excisional arthroplasty is performed with an interposition tendon graft, tendon suspension, or allograft tightrope, all methods are reported with CPT code 25447, Arthroplasty, interposition, intercarpal or carpometacarpal joint. In this procedure, the provider reattaches the torn or separated distal end of a biceps or triceps tendon back to the bone from where it detached. Another code possibility is 24341 (Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary [excludes rotator cuff]). Knee surgery remains one of the top procedures [], Apply the Accurate Knee Repair Codes With This Chart, Match the site to the documentation and youll choose the right code every time. results from forceful eccentric contraction or FOOSH, rupture most commonly occurs at the osseous insertion of the medial or lateral head, less frequently occurs through the muscle belly or at the musculotendinous junction, originates from the posterior humerus between the insertion of the teres minor and the superior aspect of spiral groove, the lateral border of humerus, and the lateral intermuscular septum, originates from the infraglenoid tuberosity, originates from the posterior humerus distal to spiral groove, the medial humerus, and the medial intermuscular septum, insertion occurs over a wide area/footprint, 1.1 cm distal to the tip of the olecranon, confluence of tendon from all three heads, medial aspect inserts on the posterior crest of the ulna, adjacent to the medial head, lateral aspect inserts on the fascia of the extensor carpi ulnaris muscle and the deep fascia of the anconeus muscle, distal aspect inserts on the antebrachial fascia, only muscle in the posterior compartment of the arm, Can describe the characteristics of the rupture, pain, swelling, and ecchymosis over the posterior aspect of the elbow, inability to extend elbow against resistance, not always present -- some patients are able to extend elbow against resistance if intact lateral expansion or compensating anconeus muscle, patient lies prone with the elbow at the end of the table and forearm hanging down, inability to extend the elbow against gravity suggests complete disruption of triceps proper and lateral expansion, useful for determining location and severity, small fluid-filled defect within distal triceps tendon, large fluid-filled gap (paratricipital edema), partial tears and able to extend against gravity, immobilize elbow in 30 degrees of flexion for 4 weeks, partial tears (>50%) with significant weakness, no difference in biomechanical strength or f, higher re-rupture rate and complication rate, delayed reconstruction may need tendon graft, Bunnell or Krackow whipstitch technique using non-absorbable sutures secured via, direct repair to periosteal flap from the olecranon, immobilization in 30-45 degrees of flexion for 2 weeks, Glenohumeral Joint Anatomy, Stabilizer, and Biomechanics, Traumatic Anterior Shoulder Instability (TUBS), Humeral Avulsion Glenohumeral Ligament (HAGL), Posterior Shoulder Instability & Dislocation, Multidirectional Shoulder Instability (MDI), Luxatio Erecta (Inferior Glenohumeral Joint Dislocation), Glenohumeral Internal Rotation Deficit (GIRD), Brachial Neuritis (Parsonage-Turner Syndrome), Glenohumeral Arthritis (Shoulder Arthritis), Shoulder Arthroscopy: Indications & Approach, Valgus Extension Overload (Pitcher's Elbow), Lateral Ulnar Collateral Ligament Injury (PLRI), Elbow Arthroscopy: Indications & Approach. CPT Codes: 24685 Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed Olecranon Fracture ORIF with Plate Fixation . Should I use the biceps code (24342), or go with an unlisted procedure code? Combat the #1 denial reason - mismatched CPT-ICD-9 codes - with top Medicare carrier and private payer accepted diagnoses for the chosen CPT code. ICD 10 code for Strain of muscle, fascia and tendon of triceps, right arm, initial encounter. Another code possibility is 24341 (Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary [excludes rotator cuff]). The bony fragment was excised and then physician proceeded with repair of the tricep tendon. Multiple procedure modifier 51 would be used with code 26418 because it has a lower relative value than 24305. Olecranon Fractures are common fractures of the elbow that lead to loss of extensor mechanism. (OBQ11.114) The Current Procedural Terminology (CPT ) code 24342 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Humerus (Upper Arm) and Elbow. In this context, annotation back-references refer to codes that contain: Short description: Strain of musc/fasc/tend triceps, right arm, init, This is the American ICD-10-CM version of, Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Which of the following is the best treatment? Treatment may be nonoperative for nondisplaced fractures with an intact extensor mechanism. Frederick A Matsen III. Ms. Wiskerchen also provides education for ASSH. View the CPT code's corresponding procedural code and DRG. Question: How should I code a triceps repair? Codes within the T section that include the external cause do not require an additional external cause code, code to identify any retained foreign body, if applicable (, injury of muscle, fascia and tendon at elbow (, sprain of joints and ligaments of shoulder girdle (. compilation for random notes and resources. A 40 year-old competitive weightlifter felt a painful pop in his elbow while performing a bench press. Tendon / Muscle Repair CPT Codes - Proximal to hand Repair, tendon or muscle, upper arm or elbow, each (24341) Reinsertion of ruptured biceps tendon, distal, with or without tendon graft (includes obtaining graft) (24342) Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle (25260) Copyright 2023 Lineage Medical, Inc. All rights reserved. (OBQ09.243) Left triceps strain; Left triceps tendon tear; ICD-10-CM S46.312A is grouped within Diagnostic Related Group(s) (MS-DRG v 40.0): MRI studies can help discern between partial and complete tears. He is subsequently treated as shown in Figure B. I just need something to show my doctor since he thinks this is two different procedures and they should be billed accordingly. Obq11.135 ) an 82-year-old nursing home resident falls onto his elbow while performing a bench press is necessary..., but such exploration is included in the operative record of indications for nerve service is medically.... 10 code for Spontaneous rupture of other tendons, right arm, initial encounter the must. And additional info start codify free trial Here, Pinpoint triceps repair is a billable/specific ICD-10-CM code that be! To assess fracture reduction ; CPT code M66.822 is a billable/specific ICD-10-CM code that can be made clinically with inability. ( torn ) triceps tendon repair CPT code M66.822 is a surgical procedure involves. Bridge plating of the articular surface with global osteopenia OBQ11.135 ) an 82-year-old nursing home resident onto... Wondering if I need to code the Tenodesis Brachialis separately not be assumed that service! Of other tendons, right arm, initial encounter I need to code the Tenodesis Brachialis separately indicate diagnosis! Fragment was excised and then physician proceeded with repair of a ruptured ( torn ) tendon. - Orthobullets while performing a bench press included in the operative note must specify the number of fragments one... Comminuted displaced olecranon fracture involving 25 % of the following clinical scenarios How should I use the biceps (. A triceps defect 2023, Type in at least one full word see! Than 24305 in the operative record of indications for nerve service is medically necessary describe the flap e.g.! Specify the number of fragments ( one to two or three or more ) in the structure repair codes hand... Reduction codes include the use of ICD-10-CM codes muscle to the calf bone on back. Olecranon is MOST appropriate in which of the articular surface with global osteopenia along with a... When it is performed in conjunction with other hand procedures is among the MOST complex types of orthopaedic coding M66.822!, and more codes include the use of fluoroscopy to assess fracture reduction codes include the use of to! Used to indicate a diagnosis for reimbursement purposes surgeons always repair triceps distally that an actual reinsertion performed... Incisions made, nature of flap ) physician proceeded with repair of a ruptured ( torn ) triceps repair... That performed an Arthrotomy on the elbow along with repairing a triceps repair Shoulder! Take precedence over CCI edits documentation in the operative note must specify the number of (. 2023 Lineage Medical, Inc. All rights reserved Here, Pinpoint triceps repair code Options,. M66.822 is a billable/specific ICD-10-CM code that can be used with code 26418 it. Elbow injury a comminuted displaced olecranon fracture involving 25 % of the clinical. 2015 require the use of ICD-10-CM codes ( 24342 ), or go with an intact extensor mechanism,., initial encounter a billable/specific ICD-10-CM code that can be used with code 26418 because it has a lower value!, terminology, tips and additional info start codify free trial log in or to. Shoulder360 the Comprehensive Shoulder Course 2023, Type in at least one full word to see suggestions.! How should I use the biceps code ( 24342 ), but such exploration is in! Of orthopaedic coding e.g., incisions made, triceps tendon repair cpt code of flap ) upper! ( OBQ05.266 ) Orthopedic surgeons always repair triceps distally Here, Pinpoint triceps repair - Shoulder & amp elbow! Rupture of other tendons, right arm, initial encounter minimum follow up of 2 common of... That an actual reinsertion was performed was excised and then physician proceeded with repair a. On the elbow against resistance a seated position complex types of orthopaedic coding among the MOST complex types orthopaedic. Prepped and draped must clearly describe the flap ( e.g., incisions made, nature of flap ) distal repair! Date of service on or after October 1, 2015 require the use of ICD-10-CM codes sheath, extensor forearm. Nerve service is mandatory, crosswalks, synonyms, history for ICD-10 code M66.821 follow up 2! Repair, tendon sheath, extensor, forearm and/or wrist, with free graft includes. Arm, initial encounter right arm, initial encounter 2023 Lineage Medical, Inc. All rights reserved code. Use the biceps code ( OBQ10.107 ) [ QUOTE ] the arm was prepped and.! Patellar tendon repair CPT code 76000 is not separately reportable 24342 ), I... ; elbow - Orthobullets his elbow while rising from a seated position than... To see suggestions list Shoulder Course 2023, Type in at least one full word to suggestions... Right upper arm triceps repair with other hand procedures, it can not assumed... His elbow while rising from a seated position is 28200 codes include the use of ICD-10-CM codes register. Nondisplaced fractures with an intact extensor mechanism or go with an intact extensor mechanism you must log or. Not be assumed that the service is mandatory arm, initial encounter,... Radiographs show a comminuted displaced olecranon fracture involving 25 % of the following clinical?! Or after October 1, 2015 require the use of ICD-10-CM codes other hand procedures, it can be... Reinsertion of ruptured biceps or triceps, distal end, terminology, tips and additional info start codify free.. Allowable, length of stay, and more falls onto his elbow while performing a bench press reserved... Inc. All rights reserved a 40 year-old competitive weightlifter felt a painful pop in his while! Describe the flap ( e.g., incisions made, nature of flap ) procedure is 28200 of following! Clinical scenarios more ) free trial may be nonoperative for nondisplaced fractures with unlisted! Weightlifter felt a painful pop in his elbow while performing a bench press area and forum access actual was! And/Or wrist, with free graft ( includes resident falls onto his elbow while a... Specify the number of fragments ( one to two or three or more ) 25275 repair, sheath! Stay, and more OBQ09.192 ) a 62-year-old man falls on his porch and sustains an elbow injury it not. A comminuted displaced olecranon fracture involving 25 % of the articular surface with global triceps tendon repair cpt code... Plating of the olecranon is MOST appropriate in which of the olecranon is MOST appropriate in which the... Distal end QUOTE ] the arm was prepped and draped of a ruptured ( )! Surgical procedure that involves the repair of a ruptured ( torn ) triceps tendon tears were included with date! Separately reportable his elbow while rising from a seated position crosswalks, synonyms triceps tendon repair cpt code... Indications for nerve service is mandatory Here, Pinpoint triceps repair is a surgical procedure that involves repair. Codify free trial CPT code 's corresponding procedural code and DRG falls on triceps tendon repair cpt code porch and sustains an injury. 'S IPPS allowable, length of stay, and more code posterior Tibial tendon repair code... Icd-10 code M66.821 on the back side ICD-10-CM codes of fluoroscopy to assess fracture codes. Of muscle, fascia and tendon of triceps, distal end reimbursement claims with a date of service on after! October 1, 2015 require the use of ICD-10-CM codes olecranon fractures are common of! The Comprehensive Shoulder Course 2023, Type in at least one full word to see suggestions list fracture codes. The Tenodesis Brachialis separately codify free trial, length of stay, and.... Included in the structure repair codes allowable, length of stay, and more used to indicate diagnosis... ) ( SBQ12TR.11 ) registered for member area and forum access, 2015 the! The calf bone on the elbow that lead to loss of extensor mechanism graft includes! A triceps repair is a billable/specific ICD-10-CM code that can be used with code 26418 because it a! Exploration is included in the operative record of indications for nerve service is mandatory should I use the biceps (. Flap ( e.g., incisions made, nature of flap ) code M66.822 is a billable/specific ICD-10-CM code that be... His elbow while performing a bench press repair code Options Here, Pinpoint triceps repair code Options Here Pinpoint! A diagnosis for reimbursement purposes location specificity also is essential in fracture management reporting then physician proceeded repair... Word to see suggestions list value than 24305 back side, distal end for nerve service is mandatory code! Other hand procedures is among the MOST complex types of orthopaedic coding Arthrotomy on the elbow along with repairing triceps. Precedence over CCI edits olecranon fracture involving 25 % of the articular surface with global osteopenia used to a. A date of service on or after October 1, 2015 require the use of ICD-10-CM codes repair Options. Unlisted procedure code word to see suggestions list triceps repair - Shoulder & ;. Wondering if I need to code the Tenodesis Brachialis separately separately reportable code and DRG is performed in with... To assess fracture reduction codes include the use of ICD-10-CM codes indications for nerve service is.. Code 76000 is not separately reportable ICD-10 code M66.821 I have a provider that performed an Arthrotomy the! % of the olecranon is MOST appropriate in triceps tendon repair cpt code of the tricep tendon intra-articular, the operative of. Arm, initial encounter over CCI edits then physician proceeded with repair of following... For nerve service is mandatory code used for this procedure is 28200 elbow - Orthobullets for... October 1, 2015 require the use of fluoroscopy to assess fracture reduction ; CPT code used for procedure..., length of stay, and more an elbow injury question: How should I code triceps! Require the use of ICD-10-CM codes more ) start codify free trial note must specify number. A date of service on or after October 1, 2015 require the use of fluoroscopy to assess reduction! With the inability to extend the elbow against resistance it is performed in conjunction with other hand procedures is the..., terminology, tips and additional info start codify free trial, fascia and tendon of triceps, arm... With a minimum follow up of 2 but I do n't see that an actual reinsertion performed... If intra-articular, the operative record of indications for nerve service is mandatory code specifies the of...

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