Chronic paroxysmal hemicrania, not intractable
ICD-10 G44.049 is a billable code used to indicate a diagnosis of chronic paroxysmal hemicrania, not intractable.
Chronic paroxysmal hemicrania (CPH) is a rare primary headache disorder characterized by recurrent, unilateral headaches that occur in clusters. These headaches are typically short-lived, lasting from 2 to 30 minutes, but can occur multiple times a day. Unlike other headache disorders, CPH is distinguished by its response to indomethacin, a nonsteroidal anti-inflammatory drug. The term 'not intractable' indicates that the condition is manageable and does not lead to persistent, unmanageable symptoms. Patients often experience significant disability during headache episodes, which can be triggered by various factors, including stress, certain foods, and changes in sleep patterns. Understanding the triggers and implementing preventive treatments are crucial for managing CPH effectively. Preventive treatments may include lifestyle modifications, pharmacological interventions, and addressing any underlying conditions that may exacerbate the headaches.
Detailed headache diaries, medication response records, and trigger identification.
Patients presenting with recurrent unilateral headaches, especially those unresponsive to typical migraine treatments.
Neurologists should ensure thorough documentation of headache patterns and treatment responses to support the diagnosis.
Comprehensive pain assessments and treatment plans that include pharmacological and non-pharmacological interventions.
Patients seeking relief from chronic headache pain, particularly those with a history of medication overuse.
Pain management specialists should document the impact of headaches on daily functioning and quality of life.
Used for follow-up visits for patients with chronic paroxysmal hemicrania.
Document history of present illness, review of systems, and treatment response.
Neurologists should ensure comprehensive documentation to support the level of service billed.
The primary treatment for chronic paroxysmal hemicrania is indomethacin, which is effective in alleviating headache episodes. Preventive treatments may also be considered based on individual patient needs.
