Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: NEU09
MultiStage: No
DXCat Label: Headache Specificity: A
Etiology: Idiopathic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Muscle tension headache Band-like constriction around head or feeling of tightness of the head, neck and occiput
DX 30781, 7840, 33905-33912,
33920-3393, 33942-33989;
1.02 Migraine headache Migraine
OR history of five attacks of the following symptoms:
spreading unilateral or bilateral headache
AND headache is throbbing or pulsatile
AND headache is aggravated by activities of daily living
AND headache duration ≤ 72 hrs
OR headache duration is ≤ 48 hours in children
AND history of prior migraine ‘aura’
OR nausea
OR dizziness
OR vomiting
OR photophobia
OR phonophobia
OR family history of migraine
OR diarrhea
AND no coexisting intracranial disease
DX 34600, 34601, 34610-34611,
34690, 34691, 33903-33904,
33941, 34602-34623, 34640-
34643, 34650-34653, 34670-34693;
1.03 Cluster headache Severe unilateral throbbing headache around entire half of face and head
AND periorbital edema
OR conjunctival injection
OR ipsilateral Horner’s syndrome
OR rhinorrhea
OR unilateral lacrimation
AND daily attacks for ≤ 90 minutes for ≤ 6 weeks
2.01 Acute confusional or dysphoric migraine Stage 1.02-1.03
AND agitation
AND disorientation:
AND amnesia of the event
2.02 Vertebrobasilar migraine Stage 1.02-2.01
AND vertigo resolves when headache remits
OR Romberg’s sign resolves when headache remits
OR dysarthria resolves when headache remits
2.03 Migraine headache with retinal ischemia Stage 1.02-2.02
AND visual disturbance in one eye
2.04 Migraine headache with ophthalmoplegia Stage 1.02-2.03
AND ophthalmoplegia remits when headache remits
DX 34620, 34621, 33900-33902;
STAGE 1.02-1.03 + GROUP
DISORIENT + (DX 3079, 4377,
7809);
NO;
STAGE 1.02-2.01 + DX 36284;
DX 34680, 34681;
Thursday, January 07, 2010 9:22:47 AM
©2010 Thomson Reuters. All rights reserved.