CMM-402: Greater Occipital Nerve Block

Covered: greater occipital nerve blocks (GONB) for occipital neuralgia using only anesthetic and/or steroid injectates (biologics and occipital nerve ablation are excluded), with up to six GONBs allowed per 12 months. Key requirements: comprehensive headache evaluation excluding other causes, documented diagnosis (paroxysmal stabbing pain in the GON distribution and nerve tenderness), documented clinically meaningful improvement after each injection (≥50% improvement or ≥2-point VAS), GONB combined with a self-care program, ≥4 weeks spacing from certain cervical procedures, only one invasive spinal procedure per day, and for chronic opioid users co-management plus an opioid risk plan.

"This guideline only applies to greater occipital nerve block used to treat occipital neuralgia and not to other techniques used to treat occipital neuralgia nor to other conditions treated by great..."