Chronic tension-type headache, intractable
ICD-10 G44.221 is a billable code used to indicate a diagnosis of chronic tension-type headache, intractable.
Chronic tension-type headache (CTTH) is characterized by recurrent episodes of headache that occur on 15 or more days per month, lasting hours to days. The pain is typically bilateral, pressing or tightening in quality, and of mild to moderate intensity. Intractable CTTH refers to cases that do not respond to standard treatments, significantly impacting the patient's quality of life. Triggers for CTTH can include stress, poor posture, sleep disturbances, and muscle tension. Unlike migraines, CTTH does not typically present with nausea or vomiting, and it is not aggravated by routine physical activity. Preventive treatments may include pharmacological options such as antidepressants, muscle relaxants, and lifestyle modifications aimed at reducing stress and improving posture. Non-pharmacological interventions like cognitive-behavioral therapy, physical therapy, and biofeedback can also be beneficial. Accurate diagnosis and management are crucial, as intractable cases may require a multidisciplinary approach to address both the physical and psychological components of the disorder.
Detailed patient history, including headache frequency, duration, and response to treatments.
Patients presenting with chronic headaches that have not responded to standard treatments.
Neurologists should document any neurological examinations and consider referrals for psychological evaluation if stress is a significant trigger.
Comprehensive pain assessments and treatment plans, including non-pharmacological interventions.
Patients with chronic pain syndromes that include CTTH as a component.
Pain management specialists should document the multidisciplinary approach to treatment, including physical therapy and psychological support.
Used for follow-up visits for chronic headache management.
Document the patient's headache history, treatment response, and any changes in management.
Neurologists should ensure thorough documentation of neurological assessments.
Chronic tension-type headache is characterized by its frequency (15 or more days per month) and its non-pulsating, bilateral nature, unlike migraines which are often unilateral and can be accompanied by nausea or aura.
