Chronic paroxysmal hemicrania
ICD-10 G44.04 is a billable code used to indicate a diagnosis of chronic paroxysmal hemicrania.
Chronic paroxysmal hemicrania (CPH) is a rare primary headache disorder characterized by recurrent, unilateral, and severe headache attacks that occur in clusters. Each attack typically lasts from 2 to 30 minutes and can occur multiple times a day. The pain is often described as sharp or stabbing and is usually accompanied by autonomic symptoms such as lacrimation, nasal congestion, or ptosis on the affected side. Unlike other headache disorders, CPH is responsive to indomethacin, a non-steroidal anti-inflammatory drug, which is a key diagnostic criterion. The condition predominantly affects women and can significantly impact quality of life due to the frequency and intensity of the attacks. Triggers for CPH may include stress, changes in sleep patterns, and certain foods or beverages, although these triggers can vary widely among individuals. Preventive treatments may include indomethacin, which is effective in most patients, and other medications such as verapamil or topiramate may be considered in refractory cases. Accurate diagnosis and treatment are essential for managing this debilitating condition.
Detailed headache diaries, treatment response records, and patient history.
Patients presenting with recurrent unilateral headaches, especially those unresponsive to typical migraine treatments.
Ensure documentation reflects the specific nature of the headaches and response to indomethacin.
Comprehensive pain assessments and treatment plans.
Management of chronic headache patients requiring multimodal treatment approaches.
Document all interventions and their outcomes to support coding.
Used for follow-up visits for chronic headache management.
Document patient history, examination findings, and treatment response.
Neurologists should ensure detailed headache diaries are included.
The primary treatment for chronic paroxysmal hemicrania is indomethacin, which is effective in most patients. Other medications may be considered if indomethacin is ineffective.
