Chronic paroxysmal hemicrania, intractable

This code signifies a severe, chronic headache disorder characterized by frequent, short-lasting attacks of unilateral head pain, often accompanied by autonomic symptoms (e.g., lacrimation, conjunctival injection, nasal congestion). "Intractable" indicates that the condition is resistant to standard therapeutic interventions, posing significant challenges in management.

Assign this code when documentation clearly states a diagnosis of chronic paroxysmal hemicrania that has proven refractory to treatment. This typically involves a history of multiple failed medication trials or other interventions. Supporting documentation should detail the chronic nature, paroxysmal attacks, unilateral pain, and the lack of response to therapy.

• Ensure documentation explicitly states "intractable" or describes treatment resistance; otherwise, use the non-intractable code.
• Distinguish from other trigeminal autonomic cephalalgias (TACs) like cluster headache or hemicrania continua, which have distinct diagnostic criteria.
• Code any associated autonomic symptoms or complications separately if they meet criteria for additional diagnoses.