If your neurologist or pain specialist administers greater occipital nerve blocks, don’t let coding turn into a headache. Verify specifics about the patient’s headache and the service your provider offered to pinpoint the correct diagnosis and procedure codes every time. Our 4 questions will point you to the best diagnosis and injection codes.

Where Is the Occipital Nerve?

The greater occipital nerve (GON) originates from the posterior medial branch of the C2 spinal nerve and provides sensory innervations to the posterior area of the scalp extending to the top of the head. Physicians typically inject the GON at the level of the superior nuchal line just above the base of the skull for occipital headaches or neck pain.

Some physician practices include a small illustration in the chart that the physician can mark with various injection sites. Including this type of tool helps your physician clearly document the injection location, which helps you choose the correct nerve injection code and submit more accurate claims.

What Type of Headache Does the Patient Have?

Your physician’s documentation might include notes ranging from “occipital headache” to “occipital neuralgia” to “cervicogenic headache.” Your job is to ensure that you interpret the notes and assign the most accurate diagnosis.

Occipital headache: ICD-9’s alphabetic index does not include a specific listing for occipital headache. Because of this, report the general code 784.0 (Headache), which includes “Pain in head NOS.” More details in your provider’s notes might lead to diagnoses such as 307.81 (Tension headache), 339.00 (Cluster headaches), 339.1x (Tension type headache), or 346.xx (Migraine).

Occipital neuralgia: You have a more specific diagnosis to code when your provider documents occipital neuralgia. Greater occipital neuralgia produces an aching, burning, or throbbing pain or a tingling or numbness along the back of the head. You’ll report diagnosis 723.8...