# RF Greater & Lesser Occipital Nerves



## joanne71178 (May 9, 2013)

Would the correct coding for this procedure be 64640x2 since this is RadioFrequency? I have done a lot of research and have read to use 64405 for Greater Occipital and 64450 for Lesser Occipital, those codes are for Nerve Blocks, not RF. 

Any comments are appreciated. 
Thanks in advance!


'Following appropriate time for the anesthetic effect and under fluoroscopic guidance 20g 60mm Sharp Tip Baylis BMC Curved Needle with a 10mm Active Tip was advanced incrementally under fluoroscopic guidance into the Right Greater Occipital Region. Proper needle position was confirmed with AP and Lateral views. Following the proper localization, sensory stimulation was documented at less than 0.5 volts. The same technique described above was utilized at the Left Greater Occipital Region , Right Lesser Occipital Region.' 
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## dwaldman (May 9, 2013)

I agree if they are separate individual lesioning, one for the greater and one for the lesser occipital nerve if this is non-pulsed radiofrequency you could use 64640 x2. But I did not see the temp or the time that they are performing the lesioning to confirm this is non-pulsed.


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## joanne71178 (May 10, 2013)

5 mLs of 2% Preservative Free LIdocaine was drawn.  Prior to lesioning a total of 5 mLs was injected approximately equally among the injection site(s). 

Standard Lesioning was carried out at 60 degrees Celsius for 80 seconds at each needle site. 

The needles were rotated.  Standard lesioning was then carried out at 60 degrees Celsius for 80 seconds at each needle site for a second time. 

The needles were rotated.  Standard lesioning was then carried out at 60 degrees Celsius for 80 seconds at each needle site for a third time. 

The needles were then withdrawn in total.  There was no abnormality and they were fully intact.  No remnants were noted on follow up fluoroscopy.  There were no apparent complications. 

Thank you


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