AAPC - July Freedom Sale

Results 1 to 4 of 4

Thread: 64405

  1. #1
    Join Date
    Apr 2007
    Posts
    12

    Default 64405

    What is the difference between a suboccipital nerve block and a greater occipital nerve block? Are they the same? Are both reported with 64405?
    Cindy

  2. #2
    Join Date
    Apr 2007
    Posts
    1,473

    Default

    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.

    Suboccipital nerve

    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.

  3. #3

    Default CPT code for Lesser Occipital Block

    A lesser occipital block is coded as 64413. Here is a link:

    http://www.arapmi.org/maraa-book-project/Chapt6.pdf

    This is a document that speaks about Cervical Plexus Blocks. Please look at the first paragraph, line 4 thru 6, under the ANATOMY heading.

    Plus, an internal document that we use at the facility where I work indicates, "Use code 64413 for a Somatic Nerve Block at the C2-C4 level (Lesser Occipital, Greater Auricular, and Supraclavicular Nerves)"

    BUT, there was an earlier thread on this subject on this forum that supported code 64450. See that discussion at the link below:

    http://www.aapc.com/memberarea/forum...ad.php?t=14173


    Richard Mann, your pain management coder
    rkmcoder@yahoo.com

  4. #4
    Join Date
    Apr 2007
    Posts
    1,473

    Default

    2017 ICD-10-CM Coding Book
    'The physician anesthetizes the cervical plexus for sympathetically mediated pain and anesthesia to the back of the neck and head. The physician draws a local anesthetic into three syringes and injects near the transverse processes of C2 to C4, avoiding vascular injection."

    Here is a description from encoder for 64413. The only question I would have would be is the work involved better reflected with 64450 RVU 1.86 compared to 64413 RVU 2.09 since they are talking about using three syringes with possible fan-like injection compare blocking just the lesser occipital nerve.

    If someone was auditing the encounter and they look at 64413. They could say I don't see mention of blocking the cervical plexus, but if you have 64450 it equates with blocking one nerve.

Similar Threads

  1. 64405
    By gbehrendt in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 09-09-2015, 06:52 AM
  2. 64405 as a bilateral
    By kimmerham in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 12-19-2011, 09:51 AM
  3. 64405
    By anggand@aol.com in forum E/M
    Replies: 5
    Last Post: 09-07-2011, 09:34 PM
  4. 64405
    By JulieK in forum Anesthesia
    Replies: 1
    Last Post: 11-29-2010, 11:00 PM
  5. 64405 with 77002
    By nyyankees in forum Anesthesia
    Replies: 2
    Last Post: 11-12-2010, 02:50 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.