Nerve Graft with Radical Prostatectomy

This policy addresses nerve grafting (e.g., sural or alternative donor nerve grafts) performed at the time of radical prostatectomy to reconstruct resected cavernous/neurovascular bundles and attempt to reduce postoperative erectile dysfunction in patients undergoing unilateral or bilateral neurovascular bundle resection. Major limitations: evidence is insufficient and a randomized trial showed no significant potency benefit (stopped for futility), the procedure is considered experimental/investigational/unproven, there are no specific CPT codes for cavernous nerve grafting, and no national Medicare coverage determination (coverage varies by local carriers).

"Nerve grafting at the time of radical prostatectomy to reduce the risk of postoperative erectile dysfunction."

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