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ICD-10 Guide
ICD-10 CodesG44.031

G44.031

Billable

Episodic paroxysmal hemicrania, intractable

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

Code Description

ICD-10 G44.031 is a billable code used to indicate a diagnosis of episodic paroxysmal hemicrania, intractable.

Key Diagnostic Point:

Episodic paroxysmal hemicrania is a rare type of primary headache disorder characterized by recurrent, unilateral headaches that are typically short in duration but occur frequently throughout the day. The intractable form of this condition indicates that the headaches are resistant to standard treatments and significantly impair the patient's quality of life. Patients often experience severe, stabbing pain localized to one side of the head, accompanied by autonomic symptoms such as lacrimation, nasal congestion, or ptosis. The headaches can be triggered by various factors, including changes in sleep patterns, stress, certain foods, and hormonal fluctuations. Unlike other headache disorders, episodic paroxysmal hemicrania responds well to indomethacin, a nonsteroidal anti-inflammatory drug, which can help alleviate symptoms. However, intractable cases may require more aggressive treatment strategies, including preventive medications and lifestyle modifications to manage triggers effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between episodic and chronic forms of hemicrania
  • Identifying intractable cases that do not respond to standard treatments
  • Documenting specific headache characteristics and triggers
  • Understanding the nuances of headache classifications

Audit Risk Factors

  • Inadequate documentation of headache frequency and duration
  • Failure to document treatment responses or lack thereof
  • Misclassification of headache types
  • Insufficient detail on associated symptoms

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed headache diaries, treatment history, and response to medications are essential for accurate coding.

Common Clinical Scenarios

Patients presenting with recurrent unilateral headaches that do not respond to typical migraine treatments.

Billing Considerations

Neurologists should ensure comprehensive documentation of headache characteristics and treatment efficacy.

Pain Management

Documentation Requirements

Records of pain management strategies, including medication trials and alternative therapies.

Common Clinical Scenarios

Patients with chronic pain syndromes who also experience episodic paroxysmal hemicrania.

Billing Considerations

Pain management specialists should document the impact of headaches on overall pain management strategies.

Coding Guidelines

Inclusion Criteria

Use G44.031 When
  • According to ICD
  • 10 guidelines, G44
  • 031 should be used when the patient has episodic paroxysmal hemicrania that is classified as intractable
  • Documentation must support the diagnosis, including headache frequency, duration, and treatment history

Exclusion Criteria

Do NOT use G44.031 When
  • Exclusion criteria include other headache disorders that may mimic symptoms

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits to manage headache treatment plans.

Documentation Requirements

Document the patient's headache frequency, severity, and response to treatment.

Specialty Considerations

Neurologists should ensure that all relevant headache characteristics are documented.

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. G44.031 provides a clear distinction for intractable cases, which can impact treatment reimbursement and management strategies.

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. G44.031 provides a clear distinction for intractable cases, which can impact treatment reimbursement and management strategies.

Reimbursement & Billing Impact

reimbursement and management strategies.

Resources

Clinical References

  • •
    American Headache Society

Coding & Billing References

  • •
    American Headache Society

Frequently Asked Questions

What distinguishes episodic paroxysmal hemicrania from other headache types?

Episodic paroxysmal hemicrania is characterized by short, severe unilateral headaches that occur multiple times a day and respond specifically to indomethacin, distinguishing it from other headache types such as migraines.