© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 64744 involves the transection or avulsion of the greater occipital nerve, which is a critical intervention aimed at alleviating chronic pain. The greater occipital nerve is a spinal nerve that originates between the first and second cervical vertebrae, specifically emerging from the suboccipital triangle. This nerve ascends to innervate the skin on the posterior aspect of the scalp, extending to the top of the head. The procedure typically begins with a skin incision made over the posterolateral aspect of the second cervical vertebra (C2). Following the incision, the surrounding soft tissues are carefully dissected to expose the greater occipital nerve as it emerges from the transverse process of C2 and the inferior oblique muscle. Once identified, the nerve is isolated, and the transection is performed by grasping the nerve and dividing it. In some cases, avulsion may be achieved by twisting the nerve over a hemostat, or alternatively, the nerve may be stretched, ligated, and divided first distally and then proximally, allowing the proximal end to retract into deeper tissues. After the procedure, the soft tissues are closed in layers, ensuring proper healing and recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of transection or avulsion of the greater occipital nerve is indicated for the treatment of chronic pain conditions that are associated with the greater occipital nerve. This may include:
The procedure involves several critical steps to ensure the successful transection or avulsion of the greater occipital nerve. These steps include:
Post-procedure care involves monitoring the patient for any immediate complications and managing pain effectively. Patients may experience some discomfort at the incision site, which can be managed with appropriate analgesics. Follow-up appointments are essential to assess the healing process and the effectiveness of the procedure in alleviating chronic pain. Patients are typically advised on activity restrictions to promote optimal recovery and prevent strain on the surgical site.
| Short Descr | INCISE NERVE BACK OF HEAD | Medium Descr | TRANSECTION/AVULSION GREATER OCCIPITAL NERVE | Long Descr | Transection or avulsion of; greater occipital nerve | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 9 - Other OR therapeutic nervous system procedures |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.