cpt 64405, cpt code 64405, 64405 cpt code

CPT Code 64405 | Description, Procedure & Billing Guidelines (2022)

Use CPT 64405 for injection(s) of steroid(s) or anesthetic agent(s) into the greater occipital nerve to relieve patients of nerve-related headaches.

1. What Is CPT Code 64405?

The 64405 CPT code covers injecting steroid agent(s) and/or anesthetic(s) into the patient’s greater occipital nerve. Another name for this is the optic nerve, which arises from the second cranial nerve.

2. Description

The CPT book describes CPT code 64405 as follows: “Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve.”

3. Procedure

The description of CPT 64405 means the following procedure. First, a provider preps a patient before administering one or more injections with a needle and syringe. Another name for this procedure is the occipital nerve block.

The injection(s) contain an anesthetic agent or steroid and is administered close to the patient’s greater occipital nerve, which anesthetizes the area.

The 64405 procedure is often performed to relieve a patient of intense nerve–related headache pains (occipital neuralgia), which are often caused by trauma to the back of the patient’s head.

Another reason for this procedure is to relieve the patients of cervicogenic headaches. These headaches happen in the patient’s cervical spine, the part of the neck close to the base of the skull.

This procedure is sometimes performed for diagnostic purposes.

4. How To Use CPT Code 64405

You can use CPT 64405 for one or more injections during one procedure.

CPT code 64405 is part of the merit-based incentive payment system.

You can add the RT modifier to the CPT 64404 claim if the patient injected a greater occipital nerve (GON) block on the right side and modifier LT if the procedure was performed on the left side.

Add modifier 50 to the CPT 64405 claim if you bill an occipital nerve block because this is a bilateral procedure.

5. Resources

CPT Professional 2022

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/occipital-neuralgia-headache-treatment.pdf

https://www.aetna.com/cpb/medical/data/800_899/0863.html

https://amd.ianryan.com/A%20Migraine%20Toolbox%20Module%202%20-%20Storyline%20output/story_content/external_files/Billing%20for%20Nerve%20Blocks%20-%20Mod%202.pdf

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