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ICD-10 Guide
ICD-10 CodesG44.051

G44.051

Billable

Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), intractable

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

Code Description

ICD-10 G44.051 is a billable code used to indicate a diagnosis of short lasting unilateral neuralgiform headache with conjunctival injection and tearing (sunct), intractable.

Key Diagnostic Point:

Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare type of headache disorder characterized by recurrent, brief episodes of unilateral pain that typically lasts from a few seconds to several minutes. The pain is often described as severe and is accompanied by autonomic symptoms such as conjunctival injection (redness of the eye) and tearing. Intractable SUNCT refers to cases where the headaches are resistant to standard treatments, significantly impacting the patient's quality of life. The exact pathophysiology of SUNCT is not fully understood, but it is believed to involve dysfunction in the trigeminal autonomic reflex pathways. Triggers for SUNCT can include physical exertion, changes in temperature, and certain stimuli. Preventive treatments may include medications such as lamotrigine, topiramate, or gabapentin, but the efficacy can vary among patients. Due to the intractable nature of this condition, patients often require a multidisciplinary approach for management, including pain specialists and neurologists.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Rarity of the condition leading to limited familiarity among coders.
  • Need for precise documentation of symptoms and treatment responses.
  • Differentiation from other headache disorders such as cluster headaches.
  • Potential for overlapping symptoms with other conditions, complicating diagnosis.

Audit Risk Factors

  • Inadequate documentation of headache characteristics.
  • Failure to document treatment attempts and responses.
  • Misclassification of SUNCT with other headache types.
  • Lack of evidence for intractability in the medical record.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed history of headache episodes, including duration, severity, and associated symptoms.

Common Clinical Scenarios

Patients presenting with recurrent unilateral headaches and autonomic symptoms.

Billing Considerations

Documentation should clearly differentiate SUNCT from other headache disorders.

Pain Management

Documentation Requirements

Records of treatment plans, medication trials, and patient responses.

Common Clinical Scenarios

Management of patients with intractable headache pain requiring multimodal approaches.

Billing Considerations

Focus on the effectiveness of interventions and patient quality of life.

Coding Guidelines

Inclusion Criteria

Use G44.051 When
  • According to ICD
  • 10 guidelines, G44
  • 051 should be used when the headache is characterized by the specific symptoms of SUNCT and is classified as intractable
  • Documentation must support the diagnosis and the intractable nature of the headaches

Exclusion Criteria

Do NOT use G44.051 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for SUNCT management.

Documentation Requirements

Document history of present illness, examination findings, and treatment plan.

Specialty Considerations

Neurology specialists should provide detailed headache diaries.

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, including SUNCT, which enhances the ability to track and manage these conditions effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of headache disorders, including SUNCT, which enhances the ability to track and manage these conditions effectively.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of headache disorders, including SUNCT, which enhances the ability to track and manage these conditions effectively.

Resources

Clinical References

  • •
    International Classification of Headache Disorders

Coding & Billing References

  • •
    International Classification of Headache Disorders

Frequently Asked Questions

What are the common triggers for SUNCT?

Common triggers for SUNCT include physical exertion, temperature changes, and certain sensory stimuli. Identifying triggers can help in managing the condition.