Diagnostic Codes

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Posted by John B ( on March 07, 2001 at 07:21:36:

I finally got in to see a new neurologist after moving from Tucson to Phoenix. She confirmed what my new PC provider told me and what I am finding out as I go along; my new health insurance (PacifiCare HMO) will not pay for most CH-related medications and treatments. This includes oxygen and all of the triptans. I'm going the "appeals" route; wish me luck.

Something else occurred to me, though. As I was checking out, I noticed that the doctor had checked a diagnostic code 346.20, Migraine, Variants. I asked her about it, and she said "is there a diagnostic code for cluster headaches?" I said I didn't know of one, and she said "that's why".

OK, who sets up these codes? What do we have to do to get a diagnostic code on these forms for cluster headache, classic; and another one for cluster headache, chronic? Anybody familiar with this?

John B

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