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v1.0.0
ICD-10 Guide
ICD-10 CodesG44.00

G44.00

Billable

Cluster headache syndrome, unspecified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G44.00 is a billable code used to indicate a diagnosis of cluster headache syndrome, unspecified.

Key Diagnostic Point:

Cluster headache syndrome is characterized by recurrent, severe unilateral headaches that occur in clusters or cycles. These headaches are often accompanied by autonomic symptoms such as lacrimation, nasal congestion, and ptosis on the affected side. The pain is typically described as sharp or burning and can last from 15 minutes to three hours. Patients may experience multiple attacks in a day, particularly during a cluster period, which can last weeks to months. The exact etiology remains unclear, but it is believed to involve hypothalamic activation and neurovascular mechanisms. Triggers can include alcohol consumption, smoking, and changes in sleep patterns. Unlike migraines, cluster headaches are not associated with aura and tend to occur at the same time each day, often waking patients from sleep. Treatment options include acute interventions such as oxygen therapy and triptans, as well as preventive treatments like verapamil and corticosteroids. Accurate diagnosis and management are crucial for improving the quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other headache types (e.g., migraines, tension-type headaches)
  • Need for detailed patient history to identify triggers
  • Variability in presentation and frequency of attacks
  • Potential overlap with other neurological conditions

Audit Risk Factors

  • Inadequate documentation of headache characteristics
  • Failure to document triggers and response to treatment
  • Misclassification of headache type
  • Lack of follow-up notes on treatment efficacy

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed headache diaries, descriptions of headache characteristics, and response to treatments.

Common Clinical Scenarios

Patients presenting with recurrent headaches, particularly those with a history of cluster headaches.

Billing Considerations

Ensure documentation reflects the severity and frequency of headaches, as well as any associated symptoms.

Primary Care

Documentation Requirements

Comprehensive patient history, including lifestyle factors and family history of headache disorders.

Common Clinical Scenarios

Initial evaluations of headache complaints, referrals to specialists.

Billing Considerations

Documenting the patient's response to initial treatments and any referrals made.

Coding Guidelines

Inclusion Criteria

Use G44.00 When
  • Follow official ICD
  • 10 guidelines for headache disorders, ensuring accurate documentation of symptoms, triggers, and treatment responses
  • Include specific details about the frequency and duration of headaches

Exclusion Criteria

Do NOT use G44.00 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for cluster headache management.

Documentation Requirements

Document history of present illness, review of systems, and treatment plan.

Specialty Considerations

Neurologists may require more detailed neurological examinations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of headache disorders, improving the accuracy of diagnoses and treatment tracking for cluster headaches.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of headache disorders, improving the accuracy of diagnoses and treatment tracking for cluster headaches.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of headache disorders, improving the accuracy of diagnoses and treatment tracking for cluster headaches.

Resources

Clinical References

  • •
    American Headache Society

Coding & Billing References

  • •
    American Headache Society

Frequently Asked Questions

What are the common triggers for cluster headaches?

Common triggers include alcohol consumption, smoking, strong odors, and changes in sleep patterns. Identifying and avoiding these triggers can help manage the frequency of attacks.