Hint: Follow site of needle insertion to select the accurate code.
While your physician treats a patient for occipital nerve pain, you'll require knowing what your physician does to treat it and where precisely your physician inserts the needle for correct claims. Read on for more medical billing and coding tips on how to ascertain which nerve your physician treats and the services delivered to reach at the right codes.
Build up Your Occipital Anatomy Basics
You will come across three different sets of occipital nerves in the body, thus you'll need to know that which one in particular your physician is treating. You report separate codes for procedures on each nerve.
Coding connection: To get to the accurate code, you must know the origin of the nerves, the structures these nerves supply and their distribution, and also what are the common complaints owing to involvement of these nerves in any pathology.
Identify nerve pathology: One common condition stemming from the involvement of the GON that you will frequently get to report is the occipital neuralgia. You report ICD-9 code 723.8 (Other syndromes affecting cervical region) for occipital neuralgia.
Note: When ICD-10 goes into effect, you'll report M53.82 (Other specified dorsopathies, cervical region) for occipital neuralgia.
Select Right Codes for Specific Nerves
In case of occipital neuralgia, your physician will carry out a block in an office setting excluding any radiologic guidance. You should code this as CPT code 64405 (Injection, anesthetic agent; greater occipital nerve). In case the physician diagnoses LON involvement, your physician may carry out a block for the LON excluding radiological assistance. You then report CPT code 64450 (Injection, anesthetic agent; other peripheral nerve or branch).
There is no specific CPT code for LON block procedure. CPT includes only a limited number of codes for injecting specific peripheral nerves. In case one is not specified, like LON, then CPT code 64450 is applied
You face the real challenge when your physician carries out a block for the TON.
Best code for TON: You may report CPT code 64490 (Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level) for the procedure on the TON.
Medical Billing and Coding Tip: The TON is neither anatomically nor functionally identical with the GON. Look sensibly in the procedure notes what necessitated the physician to carry out the block and where the needle was inserted for the procedure. Your physician may carry out the block on either of the occipital nerves to either diagnose or treat the patient's headache. Your physician will record the medical history and do a clinical examination to limit the choice to block a specific occipital nerve.
While your physician treats a patient for occipital nerve pain, you'll require knowing what your physician does to treat it and where precisely your physician inserts the needle for correct claims. Read on for more medical billing and coding tips on how to ascertain which nerve your physician treats and the services delivered to reach at the right codes.
Build up Your Occipital Anatomy Basics
You will come across three different sets of occipital nerves in the body, thus you'll need to know that which one in particular your physician is treating. You report separate codes for procedures on each nerve.
Coding connection: To get to the accurate code, you must know the origin of the nerves, the structures these nerves supply and their distribution, and also what are the common complaints owing to involvement of these nerves in any pathology.
Identify nerve pathology: One common condition stemming from the involvement of the GON that you will frequently get to report is the occipital neuralgia. You report ICD-9 code 723.8 (Other syndromes affecting cervical region) for occipital neuralgia.
Note: When ICD-10 goes into effect, you'll report M53.82 (Other specified dorsopathies, cervical region) for occipital neuralgia.
Select Right Codes for Specific Nerves
In case of occipital neuralgia, your physician will carry out a block in an office setting excluding any radiologic guidance. You should code this as CPT code 64405 (Injection, anesthetic agent; greater occipital nerve). In case the physician diagnoses LON involvement, your physician may carry out a block for the LON excluding radiological assistance. You then report CPT code 64450 (Injection, anesthetic agent; other peripheral nerve or branch).
There is no specific CPT code for LON block procedure. CPT includes only a limited number of codes for injecting specific peripheral nerves. In case one is not specified, like LON, then CPT code 64450 is applied
You face the real challenge when your physician carries out a block for the TON.
Best code for TON: You may report CPT code 64490 (Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level) for the procedure on the TON.
Medical Billing and Coding Tip: The TON is neither anatomically nor functionally identical with the GON. Look sensibly in the procedure notes what necessitated the physician to carry out the block and where the needle was inserted for the procedure. Your physician may carry out the block on either of the occipital nerves to either diagnose or treat the patient's headache. Your physician will record the medical history and do a clinical examination to limit the choice to block a specific occipital nerve.
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