CPT® Code 64744

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.