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February 2019

Clarification: Sphenopalatine ganglion block for headache, CPT codes *64505 and *64999

In the November billing chart, we included the Sphenopalatine Ganglion Block for Headache Policy (CPT codes *64505 and *64999) in the experimental procedures section. We want to clarify that the codes may have different coverage positions, such as established or experimental, in other medical policies.

The policy stated in the chart read:

Sphenopalatine ganglion blocks are considered experimental for all indications, including but not limited to the treatment of migraines and non-migraine headaches. This policy is effective Nov. 1, 2018.

It should have included the following:

Individual policy criteria determine the coverage status of the procedure codes mentioned in this policy. Tests listed in this policy may have different coverage positions (such as established or experimental/investigational) in other medical policies.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2018 American Medical Association. All rights reserved.