# Refractory migraine



## buckeye56 (Apr 29, 2013)

I need to code an acute refractory migraine headache and am unsure about the 5th digit.  The word "intractable" occurs nowhere in the patient record so I tend to believe I can code only 346.90, despite the refractory diagnosis.  Would appreciate hearing from someone who knows for sure.  Thank you.


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## moore509 (Apr 30, 2013)

My opinion is to use the 5th digit 1 because "refractory" is mentioned.  Also, because you don't mention a time frame and say "acute", it is not status migrainosus (lasting 72 hours).  Just my interpretation.


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