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Anesthesia Coding Alert

Reader Questions:

Confirm Nerve, Location for Occipital Destruction

Published on Mon Feb 05, 2007

Question: How should I code occipital nerve destruction? Indiana Subscriber Answer: Coders and payers sometimes have different answers for this question; some recommend 64640 (Destruction by neurolytic agent; other peripheral nerve or branch) because none of CPT's destruction codes specifies the occipital nerve. Other coders, however, believe 64626 (Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level) is a better option because of the nerve location. Correct coding could depend on two factors: which occipital nerve the physician destroyed (greater, lesser or third) and the anatomical site of destruction (proximal at the site of the nerve origin versus distal in the scalp region). Get these details from your physician and the procedure report to help you make the most accurate coding choice.
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