# Greater Occipital Nerve Block and Supraorbital injcection



## Melissa Harris CPC (Jul 25, 2014)

Can someone give me some direction on billing this??  I believe it is 64405 for the bilateral greater occipital nerve block but for the supraorbital injection I am not sure if that is a 20552 or is that a lesser occipital nerve.  My doc chose 64450 50 and 20552 which I think is incorrectl
Thank you!



PROCEDURE-Bilateral Greater Occipital Injection and Supraorbital Injection



INDICATIONS:Headache 

DESCRIPTION OF PROCEDURE: 
INJECTATE: 5 mL of  .25% Marcaine, 1 mL of 6mg/mL Celestone

DESCRIPTION OF PROCEDURE:   After informed consent was obtained, the patient was brought to the procedure room and placed in the procedure table in the prone position.  I palpated the inion and then marked the spot one third the distance between the inion and the mastoid process on the Right and Left sides along the nuchal ridge.  At the spot after cleansing the skin with alcohol I injected the bilateral greater occipital nerve with an anesthetic, 2 cc each side of the above injected.  I then had the patient roll over and assume the supine position.  I palpated for the Right supraorbital notch and then cleansed above the eye with an alcohol wipe, I then advanced a 25-gauge 1-1/2 inch needle downward to  the Right supraorbital notche and injected 1 cc of the above injectate then removed the needle. This was repeated on the Left side ustilizing the remaining cc of the above injectate.   Band-Aids were placed on the injection sites.  There were no complications.  The patient tolerated this procedure well.


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## abyrne (Jul 25, 2014)

You would report cpt 64400 for the supraorbital nerve block (64400: Injection, anesthetic agent; trigeminal nerve, any division or branch (used for supraorbital nerve block, pain block))

You would report cpt 64405 (with 50 modifier) for the bilateral greater occipital nerve block (64405: Injection, anesthetic agent; greater occipital nerve (used for occipital neuralgia)).

Hope this helps !

Alaina


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## Melissa Harris CPC (Jul 28, 2014)

Thank you Alaina!!


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