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2025 ICD-10-CM code G44.201

Intractable unspecified tension-type headache. This signifies head pain caused by persistent muscle tension in the neck or scalp, unresponsive to standard treatments.

The code G44.201 is used when the provider does not specify whether the intractable tension-type headache is episodic or chronic. If the provider documents the headache as episodic or chronic, the appropriate code (G44.211 or G44.221) should be used instead.

No modifiers are applicable to ICD-10-CM codes.

Medical necessity for the use of G44.201 is established when the documentation clearly supports the diagnosis of an intractable tension-type headache. The documentation must demonstrate that the headache is unresponsive to conservative treatments, justifying the need for further intervention or management.

Clinicians diagnose intractable unspecified tension-type headaches based on patient history, symptoms, and physical examination.Common diagnostic indicators include trigger points in the neck and shoulder muscles. Treatment may involve various approaches, including medication (NSAIDs, aspirin, acetaminophen with caffeine), trigger point injections (with local anesthetics and/or corticosteroids), and preventive therapies such as amitriptyline (a tricyclic antidepressant). Other recommended therapies can include biofeedback, relaxation techniques, cognitive behavioral therapy (CBT), and physical therapy.

In simple words: This type of headache is caused by tense muscles in your head and neck. It's called "intractable" because it doesn't get better with usual treatments. Doctors haven't figured out if it happens occasionally or all the time.

Intractable unspecified tension-type headache is characterized by head pain attributed to muscle tension or contraction in the neck and scalp muscles.It is considered "intractable" due to its unresponsiveness or poor response to treatment.The classification as "unspecified" indicates a lack of documentation regarding whether the headache is episodic (occurring fewer than 15 times a month) or chronic (occurring more than 15 times a month).

Example 1: A 45-year-old patient presents with a constant, tight band-like sensation around their head. They report having these headaches almost daily for the past year, and various over-the-counter pain relievers have provided little to no relief. Trigger points are identified in the trapezius muscles. The headaches interfere with their daily activities and sleep. This scenario warrants the code G44.201 as the headache is unresponsive to treatment and its episodic or chronic nature is not specified., A 60-year-old patient experiences persistent headaches multiple times a week, described as a dull ache in the back of the neck and scalp. The headaches have been present for several months and have not responded to physical therapy and NSAIDs. Further examination reveals tenderness in the neck and shoulder muscles. As the headache is unresponsive to treatment and its frequency is not clearly defined as episodic or chronic, G44.201 is applicable., A 30-year-old patient complains of near-daily headaches for the past six months. The pain is described as a squeezing sensation around the head. They've tried several medications, including amitriptyline, with minimal improvement.The physician notes muscle tension in the neck and shoulders during the examination. Due to the lack of response to treatment and the unspecified nature of the headache's frequency, G44.201 is the appropriate code.

Documentation should include the following:

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