# Greater occipital nerve block



## larkatin (Aug 18, 2009)

Doctor dictates: Bilateral greater and lesser occipital nerve blocks were done
with a total of 12 mL (3 mL each) 0.25% bupivicaine with
1:200,000 epinephrine using a 25-gauge, 1-1/2-inch needle and
aseptic technique. Prior to the injection, a local wheal was
raised at each site with approximately 0.1 mL of 1% lidocaine
plain via a TB needle.  The patient tolerated these injections
well and no bleeding was noted following the injections.

Greater is 64405-50, but what is the lesser occipital?  Many thanks!


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## NFBarner (Aug 24, 2009)

Lesser occipital code is 64450.


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## larkatin (Aug 24, 2009)

Thank you.


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## LuluBarr (Mar 23, 2011)

Can you use modifier 50 with 64450 other peripheral nerve block?


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## dwaldman (Mar 23, 2011)

https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx

This link has payment policy indicators which you can search 

MULT PROC 51 2 
BILAT SURG 50 1 
ASST SURG 80 1 
CO-SURG 62 0 
TEAM SURG 66 0 
MINIMUM ASST SURG 81 1 
ASST SURG (QUALIFIED RESI. NA) 82 1 
PHYSICIAN SUPERVISIONPS* 9 

"150% payment adjustment for bilateral procedures applies. If the code is billed with the bilateral modifier or is reported twice on the same day by any other means (e.g., with RT and LT modifiers, or with a 2 in the units field), base the payment for these codes when reported as bilateral procedures on the lower of: (a) the total actual charge for both sides or (b) 150% of the fee schedule amount for a single code. If the code is reported as a bilateral procedure and is reported with other procedure codes on the same day, apply the bilateral adjustment before applying any multiple procedure rules"


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## ckkohler (Mar 26, 2011)

So, out of curiosity, I opened the link provided by dwaldman - can you help me understand where you got your information? All I get when I open and download the link is a grid?? Thank you!


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## dwaldman (Mar 28, 2011)

The CMS link has the same information regarding payment policy indicators as the info I copy and pasted in the response. The info is from the Medassets site which the company I work with provides a license for me to utilize the software.


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