Episodic paroxysmal hemicrania, intractable

This code signifies a severe, recurring headache disorder characterized by frequent, short-lasting attacks of unilateral head pain, often accompanied by autonomic symptoms (e.g., lacrimation, ptosis). The "intractable" designation indicates that the condition is resistant to standard or multiple therapeutic interventions, posing significant management challenges.

Assign this code when documentation clearly states a diagnosis of episodic paroxysmal hemicrania that has proven refractory to treatment. This typically involves a history of failed trials of indomethacin or other prophylactic medications. Supporting documentation should detail the episodic nature of the attacks and the lack of response to therapy.

• Ensure documentation explicitly states "intractable" or "refractory" to justify this specific code.
• Distinguish from chronic paroxysmal hemicrania (G44.02x), which involves daily or near-daily attacks.
• Do not confuse with other trigeminal autonomic cephalalgias (TACs) like cluster headache, which have different clinical presentations and treatment responses.