(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)
The TON (third occipital nerve) is also known as the lesser occipital nerve, and would be coded either 64450 or 64413, depending on your preference. Doing an internet search, I would probably code it 64450 because most TON block info references this code. There is conflicting info on one web site that actually lumps the TON block into the facet block (http://www.algosresearch.org/Educati...uidelines.html), but since there were three injections that corresponded to two facets, then I would code your example above simply as 64490, 64491. If the TON was injected as a byproduct of the facet injections, then so much the better, but to code it you would have to use another needle just for that.
Richard Mann, your pain management coder
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