Since the 64405 specifies Greater occipital nerve I think you would follow the guidelines for billing a suboccipital nerve block the same way you would bill a lesser occipital block using 64450. I have never seen a recommendation on how to bill that block in CPT Assitant, webinar, coding site, or conference so I am not 100% sure.
I look up these definitions on this site www.mondofacto.com
Greater occipital nerve
Medial branch of the dorsal primary ramus of the second cervical nerve; sends branches to the semispinalis capitis and multifidus cervicis, but is mainly cutaneous, supplying the back part of the scalp.
Dorsal ramus of the first cervical nerve, passing through the suboccipital triangle and sending branches to the rectus capitis posterior major and minor, obliquus capitis superior and inferior, rectus capitis lateralis, and semispinalis capitis; the first cervical spinal nerve is generally considered to have only motor fibres, but the suboccipital nerve receives sensory fibres for proprioception via a communicating branch from the second cervical spinal nerve.
Lesser Occipital nerve
Arises from the ventral primary rami of the second and third cervical nerves; supplies the skin of the posterior surface of the auricle and the adjacent portion of the scalp. Posterior to the auricle.
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