Image-guided Intranasal SPG Block Effective for Migraines

by | Published on Sep 14, 2015 | Healthcare News

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A group of researchers from the Albany Medical Center and the State University New York Empire State College in Saratoga Springs found that image-guided, intranasal sphenopalatine ganglion (SPG) is effective for migraines. According to the lead study author, this innovative interventional radiology treatment offers a patient-centered therapy that has the ability to break the migraine cycle and quickly improve patients’ quality of life. Migraines are among the most common debilitating conditions in the United States. The medicine used to address migraine pain is quite costly and there are issues of side-effects as well. In such a scenario, this image-guided, targeted intranasal SPG block is a breakthrough treatment.

For this study, the research team conducted a retrospective analysis of 112 patients with migraine or cluster headaches. The severity of their headaches was reported on a visual analogue scale (VAS) ranging from 1-10 in order to quantify the degree of debilitation they experienced from the migraine. The treatment was minimally invasive without needles touching the patient. The researchers inserted a spaghetti-sized catheter through the nasal passages during the treatment and administered 4 percent lidocaine to the sphenopalatine ganglion (a nerve bundle that lies behind the nose and associated with migraines). The patients reported an average score of 8.25 before the treatment with scores greater than 4 at least 15 days each month. The day after the SPG block, the VAS scores were slashed down by half to an average of 4.10. The patients reported an average VAS score of 5.25 in thirty days after the pretreatment. Moreover, around 88 percent of patients indicated that they required less or no migraine medication for ongoing relief.

Though the treatment brings relief to the patient with migraine, the lead author opines that SPG blocks are not a cure for migraines. Instead, they are only a temporary solution like other current treatment options for chronic headaches. However, the researchers believe that patients can have the SPG block repeated owing to its minimally invasive nature and the medications’ safety profile. For further study, the researchers will track how the 112 patients responded six months post treatment. A double-blind prospective study is also under consideration to evaluate the effectiveness of SPG blocks in treating chronic migraines more rigorously.

SPG block is a historically effective procedure for chronic headache treatment and is covered by most insurance plans including Medicare. Physicians treating these patients or medical coding companies that bill for them have to report correct medical codes. Accurate medical coding is crucial for appropriate reimbursement.

It is reported using the following CPT medical code:

  • 64505: Injection, Anesthetic Agent; Sphenopalatine Ganglion

However, most physicians do not administer conventional SPG block procedures as they are invasive, uncomfortable for the patient and carry risks. Due to the lack of a safe and reliable delivery system, getting the anesthetic to the SPG is difficult. This new study shed light on a safer SPG block procedure. We can hope with further studies, image-guided intranasal SPG block can become a very effective permanent solution for migraines.

Meghann Drella

Meghann Drella possesses a profound understanding of ICD-10-CM and CPT requirements and procedures, actively participating in continuing education to stay abreast of any industry changes.

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