# Greater Occipital Nerve Block



## Jinx75 (Sep 6, 2013)

Dr performed a Bilateral GONB in office using 5ml of 1% lidocaine for bilateral occipital neuralgia.  The patient was evaluated and treated for several other condtions so we are billing 

99215-25
64405
J3490-for the lidocaine.

Is this correct to bill J3490 for the lidocaine since it was the only drug adminstered?


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## dwaldman (Sep 6, 2013)

Yes, if you are going to attempt to recoup  for the drug administered such as lidocaine that falls under J3490. 

You will see some mention on coding forums that do not attempt to be reimbursed for lidocaine while others relay they do bill for it.

I guess you have see a general consensus of the carriers you are billing if they are going to cover it. I understand your situation is only lidocaine was injected without steroid.


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## Jinx75 (Sep 9, 2013)

Thank you for taking the time to reply I sincerely appreciate it!!


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## jmueller (Feb 19, 2014)

*Dx code appropreate for billing 64405*

What would the right DX code be to bill out a 64405 for an ONB.

I was informed that 784.0 is not a valid code and was thinking of either using 723.1 or 723.8


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## dwaldman (Feb 19, 2014)

The physician I bill for that performs occipital nerve block dictates either a combination of 723.8, 729.2 with 723.8 as the first list DX. Or sometimes 723.8 784.0. I have remember receive a denial from Cigna for 784.0 as the only condition the patient had when 64405 was billed. They also have certain criteria that has to be met. United Health Care has a medical policy that states this procedure is non covered no exceptions.


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