Periodic headache syndromes in child or adult, intractable

This code signifies a chronic, recurring headache disorder that is resistant to standard medical treatment in either pediatric or adult patients. It encompasses various periodic headache types, such as migraines or cluster headaches, when they have become difficult to manage with conventional therapies. The "intractable" designation indicates a failure to achieve satisfactory relief despite appropriate and adequate treatment.

Apply this code when documentation clearly indicates a diagnosis of a periodic headache syndrome (e.g., migraine, cluster headache) that has been deemed intractable by the treating physician. This typically involves a history of multiple failed treatment regimens or persistent, severe symptoms despite ongoing therapy. Supporting documentation should detail the specific headache type, the duration of the condition, and the failed treatment attempts.

• Ensure documentation explicitly states "intractable" or describes treatment resistance; otherwise, a non-intractable code for the specific headache type may be more appropriate.
• Do not use this code for acute headache episodes or for headaches that are responsive to treatment.
• Consider sequencing this code as the primary diagnosis if the intractable headache is the main reason for the encounter, followed by codes for any associated symptoms or complications.