ICD-10 Coding for Tension Headache(G44.201, G44.209, G44.221)
Complete ICD-10-CM coding and documentation guide for Tension Headache. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Tension Headache
G44.2Primary Range
Tension-type headache
This range includes all codes related to tension-type headaches, differentiating between episodic and chronic, as well as intractable and not intractable forms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G44.201 | Tension-type headache, unspecified, intractable | Use when the headache is chronic and unresponsive to treatment. |
|
| G44.209 | Tension-type headache, unspecified, not intractable | Use for episodic headaches that respond to simple analgesics. |
|
| G44.221 | Chronic tension-type headache, intractable | Use for chronic headaches that are unresponsive to multiple treatments. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for tension headache
Essential facts and insights about Tension Headache
Primary ICD-10-CM Codes for tension headache
Decision Criteria
clinical Criteria
- Headache persists despite treatment with at least two prophylactic medications.
Applicable To
- Chronic tension-type headache, intractable
Clinical Validation Requirements
- Chronicity with ≥15 headache days/month
- Failure of ≥2 prophylactic medications
Code-Specific Risks
- Misclassification if intractability is not documented
Coding Notes
- Ensure documentation specifies intractability and chronicity.
G44.209 - Tension-type headache, unspecified, not intractable
Use for episodic headaches that respond to simple analgesics.
Applicable To
- Episodic tension-type headache, not intractable
Excludes
- Migraine (G43.-)
- Cluster headache (G44.0)
Clinical Validation Requirements
- Episodic occurrence with <15 headache days/month
- Responsive to over-the-counter analgesics
Coding Notes
Document frequency and response to treatment.
G44.221 - Chronic tension-type headache, intractable
Use for chronic headaches that are unresponsive to multiple treatments.
Applicable To
- Chronic tension-type headache with ≥15 headache days/month
Excludes
- Migraine (G43.-)
- Cluster headache (G44.0)
Clinical Validation Requirements
- ≥15 headache days/month for ≥3 months
- Failure of multiple treatment modalities
Coding Notes
Ensure documentation supports chronicity and intractability.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Cervicalgia
M54.2Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Migraine, unspecified, not intractable
G43.909Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Tension Headache to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G44.201.
Impact
Clinical: Misleading clinical picture of headache management., Regulatory: Potential non-compliance with coding standards., Financial: Risk of claim denials or reduced reimbursement.
Mitigation Strategy
Always document treatment attempts and failures., Clarify if headaches are responsive to treatment.
Impact
Reimbursement: May result in denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of healthcare data.
Mitigation Strategy
Ensure documentation specifies whether the headache is episodic or chronic and if it is intractable.
Impact
Risk of audits due to incorrect classification of headache as intractable or chronic.
Mitigation Strategy
Ensure comprehensive documentation of headache characteristics and treatment history.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Tension Headache, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Tension Headache
Use these documentation templates to ensure complete and accurate documentation for Tension Headache. These templates include all required elements for proper coding and billing.
Chronic Tension-Type Headache Evaluation
Specialty: NeurologyRequired Elements
- Headache frequency
- Pain description
- Treatment history
- Physical exam findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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