Episodic paroxysmal hemicrania, not intractable

This code identifies a specific type of primary headache disorder characterized by frequent, short-lasting attacks of severe, strictly unilateral head pain. These attacks are accompanied by ipsilateral autonomic symptoms, such as conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, and eyelid edema. The key feature differentiating it from other trigeminal autonomic cephalalgias is its absolute responsiveness to indomethacin.

Assign this code when documentation explicitly states a diagnosis of episodic paroxysmal hemicrania that is not intractable. This diagnosis is typically made based on clinical presentation and a positive response to indomethacin. Ensure the medical record clearly distinguishes it from chronic paroxysmal hemicrania or other headache types.

• Differentiate carefully between episodic and chronic paroxysmal hemicrania; chronic forms have a different code.
• Confirm the "not intractable" status; intractable conditions have specific codes.
• Review documentation for the presence of ipsilateral autonomic symptoms and indomethacin responsiveness to support this diagnosis.