Neurosurgery Coding Alert

Question: How do we code thermocoagulation of the greater occipital nerve?

New York Subscriber

Answer: The correct choice depends on whether the physician destroys the nerve or treats it with pulses. For destruction, report 64640 (Destruction by neurolytic agent; other than peripheral nerve or branch). For pulsed treatments that affect the nerve but don't destroy it, submit 64999 (Unlisted procedure, nervous system) instead. Although the physician's procedural work may be similar, the pulsed treatment does not appear to create a destructive nerve lesion, precluding use of 64640.