Cluster headache is a neurological disorder that refers to a series of short but very painful headaches. Cluster headache attacks generally last between 15 minutes and 3 hours, and may occur up to 8 times a day. This is a very painful type of headache that causes intense pain in or around one eye on one side of the head. Cluster periods can last from weeks to months, usually followed by remission periods when the headaches stop. Neurology medical billing involves coding this cluster headache using relevant ICD and CPT codes.
Cluster Headache – Symptoms, Diagnosis and Treatment
During remission, no headaches occur for months and sometimes even years. Pain often occurs on one side of the head. Other common signs and symptoms during a headache include restlessness, excessive tearing, stuffy or runny nose on the affected side, redness of the eye on the affected side, forehead or facial sweating on the affected side, swelling around eye on the affected side, and drooping eyelid on the affected side.
Diagnosis for this headache type include approaches such as – neurological examination to assess the brain function, including the senses, reflexes and nerves and brain imaging tests such as MRI or CT scan.
Treatment options aim at decreasing the severity of pain, shortening the headache period and preventing the attacks. Fast-acting medications are recommended, as the cluster headache happens suddenly. Medications can reduce the number of cluster headaches and make the condition less severe. Oral medications recommended include Octreotide (Sandostatin), local anesthetics, such as lidocaine, or injectable form of dihydroergotamine (D.H.E. 45).
In certain cases, preventive therapy is recommended to suppress the attacks. Preventive treatments may include calcium channel blockers, corticosteroids, Lithium carbonate (Lithobid), Noninvasive vagus nerve stimulation (VNS), or occipital nerve block, depending on the length and regularity of the cluster episodes. Surgery will be recommended, only if there’s no relief with aggressive treatments. Patients may be often recommended to follow their usual sleep routine and avoid possible triggers such as smoking or alcohol consumption, especially during the cluster period. In cases of severe pain, alternative or complementary therapies help to relieve pain.
ICD-10 Codes to Report Cluster Headache
- G44.0 Cluster headaches and other trigeminal autonomic cephalgias (TAC)
- G44.00 Cluster headache syndrome, unspecified
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- G44.001 …… intractable
- G44.009 …… not intractable
- G44.01 Episodic cluster headache
- G44.011 …… intractable
- G44.019 …… not intractable
- G44.02 Chronic cluster headache
- G44.021 …… intractable
- G44.029 …… not intractable
- G44.03 Episodic paroxysmal hemicrania
- G44.031 …… intractable
- G44.039 …… not intractable
Some alternative therapies that may provide relief from cluster headaches are Acupuncture, Physiotherapy or Spinal manipulation.
Neurologists should pay close attention to documentation requirements for accurate coding and billing. In practices, in-house medical billing for such neurology condition involves many challenges such as – delay in filing multiple claims, coding errors, poor knowledge on changing coding and billing regulations, high training requirements, failing to stick to laws regarding data confidentiality, and more. Providers failing to follow the changing guidelines of neurology billing would result in incorrect claims and denied payments.
As neurology medical billing and coding are complicated and time-consuming, most practices are now relying on medical coding outsourcing companies to assign accurate codes for the treatment provided and thus receive accurate reimbursement. It is important for the partnering billing company to be knowledgeable about the concerned payer’s regulations and policies related to neurology medical billing. Professional medical billing companies will cover a wide range of services for neurologists which include insurance verification and authorization, patient enrolment and scheduling, coding, AR collections, and more. By outsourcing the billing and coding task, practices and their staff can focus better on patient care.
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Meghann Drella possesses a profound understanding of ICD-10-CM and CPT requirements and procedures, actively participating in continuing education to stay abreast of any industry changes.