# Greater & Lesser Occipital Nerve RFA



## ajkinion (Sep 21, 2011)

My provider did a left greater & left lesser occipital nerve RFA.  According to his dictation, he did not use ultrasound nor fluoroscopy.  My two questions, what CPT would I use? and is ultrasound or fluoro guidance "required" ?


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## dwaldman (Sep 22, 2011)

Alot of the articles I found on the internet were case studies--- they used pulsed radiofrequency(64999) for the greater occipital nerve, they didn't exactly describe using image guidance.  If it was non-pulsed (64640), without an LCD/medical policy for this  type of procedure it is hard to know before the carrier's response until you bill it or if you would ever receive post payment review down the road.


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## ajkinion (Sep 23, 2011)

thank you   I too tried to find something on internet & didn't come up with much.  Dictation states "two minutes of pulsative treatment was applied to both locations" (greater & lesser) so I guess I'll go with 64999    It's medicare so it's going to deny regardless unfortunately.  Thanks for the info!!  I really appreciate it!!


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