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Thread: Greater occipital nerve block

  1. #1

    Default Greater occipital nerve block

    AAPC: Back to School
    Doctor dictates: Bilateral greater and lesser occipital nerve blocks were done
    with a total of 12 mL (3 mL each) 0.25% bupivicaine with
    1:200,000 epinephrine using a 25-gauge, 1-1/2-inch needle and
    aseptic technique. Prior to the injection, a local wheal was
    raised at each site with approximately 0.1 mL of 1% lidocaine
    plain via a TB needle. The patient tolerated these injections
    well and no bleeding was noted following the injections.

    Greater is 64405-50, but what is the lesser occipital? Many thanks!

  2. #2


    Lesser occipital code is 64450.

  3. #3


    Thank you.

  4. #4


    Can you use modifier 50 with 64450 other peripheral nerve block?

  5. #5
    Join Date
    Apr 2007



    This link has payment policy indicators which you can search

    MULT PROC 51 2
    BILAT SURG 50 1
    ASST SURG 80 1
    CO-SURG 62 0
    TEAM SURG 66 0

    "150% payment adjustment for bilateral procedures applies. If the code is billed with the bilateral modifier or is reported twice on the same day by any other means (e.g., with RT and LT modifiers, or with a 2 in the units field), base the payment for these codes when reported as bilateral procedures on the lower of: (a) the total actual charge for both sides or (b) 150% of the fee schedule amount for a single code. If the code is reported as a bilateral procedure and is reported with other procedure codes on the same day, apply the bilateral adjustment before applying any multiple procedure rules"

  6. #6
    Join Date
    Apr 2007
    Omaha, Nebraska


    So, out of curiosity, I opened the link provided by dwaldman - can you help me understand where you got your information? All I get when I open and download the link is a grid?? Thank you!
    Carolyn Kohler, CPC
    Omaha, NE

  7. #7
    Join Date
    Apr 2007


    The CMS link has the same information regarding payment policy indicators as the info I copy and pasted in the response. The info is from the Medassets site which the company I work with provides a license for me to utilize the software.

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