tci ED Coding & Reimbursement Alert - 2009 Issue 13

READER QUESTIONS: Coding Migraines That Aren't Always Migraines

Question: A 46-year-old patient presents to the ED with recurring headaches. She reports that the headaches started sporadically "about five weeks ago," increasing in frequency but decreasing in severity to the point that she was having mild to moderate headaches daily that she was treating with various over-the-counter headache medications. Then, the patient had a worsening headache and eventually presented to the ED; symptoms included photophobia and phonophobia, seeing blue spots, and "crushing" pain behind her left eye. During a level-four E/M service, the physician rules out medication overuse as a cause of the most recent headache. The...

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