Chronic tension-type headache, intractable

This code signifies a persistent, daily, or near-daily headache characterized by a dull, aching, or pressure-like sensation, often bilateral, that has not responded adequately to standard treatments. "Intractable" indicates that the headache is resistant to conventional therapeutic interventions, posing significant challenges in management.

Use this code when documentation clearly states a diagnosis of chronic tension-type headache that is explicitly noted as intractable or refractory to treatment. This typically applies to patients who have undergone multiple treatment modalities without sustained relief, impacting their daily functioning.

• Ensure the physician's documentation specifically uses "intractable" or similar terms indicating treatment resistance.
• Distinguish from episodic tension-type headache (G44.201, G44.211) and other chronic headache types, such as chronic migraine.
• Always review the entire medical record for supporting evidence of chronicity (e.g., headache frequency, duration) and failed treatment attempts.