New ICD-9 Headache Diagnostic CodesMonday, September 29, 2008 |
The American Headache Society® Medical Economics Committee is composed of the following physicians: Dr. Paul Winner, Dr. Steve Silberstein, Dr. Fred Sheftell, Dr. Joel Saper, Dr Jim Couch and Dr. Stuart Black.
The first primary goal of the committee was to focus on updating the ICD-9-CM for headache syndromes. Given the advances in Headache Medicine, the existing ICD codes did not represent the current clinical spectrum of headache syndromes. In addition, there was no correlation with the International Headache Society classification of headache. This resulted in the inability to accurately link the ICD diagnosis code(s) with the services provided (CPT). An ICD code is intended to describe the clinical condition of the patient and support the medical necessity of the CPT procedure or service rendered.
To accomplish this goal, a new category of ICD codes called Other Headache Syndromes (339) was created. Within this category there are six new subcategories and 23 new codes. The existing Migraine category of codes (346) was substantially updated and 5 new codes were added.
As the new ICD codes are introduced, it is important to recognize the special contributions made by two American Headache Society® members. Both are also past presidents of the AHS. More than 15 years ago, Dr Joel Saper appeared before the appropriate ICD committee requesting that ICD codes reflect the complexity of care required in the treatment of various headache patients. Through his efforts the terminology “intractable” was adopted. Five digit ICD codes for migraine became available to provide greater specificity and a more accurate description of the patient’s clinical condition. This was an important step toward better reimbursement for the care of headache patients. The term “intractable” remains a part of the new ICD terminology.
The direction and leadership for development of the new ICD codes was provided by Dr Steve Silberstein. Working closely with American Headache Society® coding consultants, Dr Silberstein’s personal commitment of time and knowledge resulted in the current ICD code revision. Where applicable, the new codes are in correlation with the IHS headache classification.
Comparison Chart of ICD-9-CM and ICHD-2
Approval of the new ICD-9-CM headache and migraine diagnoses codes required working closely with the staff of the National Center of Health Statistics at the Centers for Disease Control. The final decision to accept the proposal was made jointly by the CDC and the Centers for Medicare and Medicaid Services (CMS). Dr Silberstein personally represented the AHS at these agencies and was the key figure in the final approval process.
The new ICD-9-CM codes will take affect October 1, 2008.
Stuart B Black, M.D; FAAN
Chair, Medical Economics Committee
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