Outpatient Facility Coding Alert

Question: Can I code a lesser occipital nerve block in addition to a greater occipital nerve block?

Illinois Subscriber

Answer: Yes, you may report these two services separately. First, you can see that there is no National Correct Coding Initiative (NCCI) edit between the greater occipital nerve block code 64405 (Injection, anesthetic agent; greater occipital nerve) and lesser occipital nerve block code 64450 (Injection, anesthetic agent; other peripheral nerve or branch).

Additionally, Volume 25, Issue 10 of the October 2016 CPT® Assistant explains that two separate injection sites are needed to perform separate greater and lesser occipital nerve blocks:

“Code 64450 is the appropriate code to report for a lesser occipital nerve block. The lesser occipital nerve is several inches away from the greater occipital nerve (code 64405), so these nerves are not reached through the same injection site. The lesser occipital nerve is at the side of the head by the ear, whereas the greater occipital nerve is at the very back of the head.”

 

 

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