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Greater & Lesser Occipital Nerve RFA

ajkinion

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My provider did a left greater & left lesser occipital nerve RFA. According to his dictation, he did not use ultrasound nor fluoroscopy. My two questions, what CPT would I use? and is ultrasound or fluoro guidance "required" ?
 

dwaldman

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Alot of the articles I found on the internet were case studies--- they used pulsed radiofrequency(64999) for the greater occipital nerve, they didn't exactly describe using image guidance. If it was non-pulsed (64640), without an LCD/medical policy for this type of procedure it is hard to know before the carrier's response until you bill it or if you would ever receive post payment review down the road.
 

ajkinion

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thank you:) I too tried to find something on internet & didn't come up with much. Dictation states "two minutes of pulsative treatment was applied to both locations" (greater & lesser) so I guess I'll go with 64999 :( It's medicare so it's going to deny regardless unfortunately. Thanks for the info!! I really appreciate it!!
 
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