# Greater and lesser occipital nerve blocks with TPI



## celcano (Dec 10, 2015)

My physician did a right greater and lesser occipital nerve block and TPI injections to the paracervical, periscapular and trapezius muscles.  I see that code 20553 is bundles into 64405 and 64450, but a modifier is allowed to differentiate between the services.  These were done during the same session.

The indication for the occipital nerve block is headache and occipital neuralgia.  The physician injected bupivacaine and Kenalog.

The indication for the TPI is myofacial pain.  The physician injected bupivacaine and Kenalog.

Is there anything here that would allow me to unbundle 20553?   

Thank you for your assistance.


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## Melissa Harris CPC (Dec 11, 2015)

Have you tried billing the 20553 with a mod XS or 59 as it is a separate procedure/location?

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management


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## celcano (Dec 14, 2015)

No.  I'm trying to determine if it is appropriate to "unbundle" the TPI injections from the greater and lesser occipital injections.


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