READER QUESTIONS:
Coding Migraines That Aren't Always Migraines
Published on Sat Oct 03, 2009
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 final diagnosis is chronic migraine without aura. I know this is a migraine. What diagnosis code best represents these symptoms? Arizona Subscriber Answer: This patient suffers from transformed migraines (TM) without aura. On the claim, report 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 [...]
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