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Outpatient Facility Coding Alert

Reader Question:

Stick to 307.9 for Unspecified Headache

Question: When we reported diagnosis code 307.81 for tension headache, the payer denied the claim, stating that it is a psychiatric code. How should we code this to get the service paid?

Michigan Subscriber 

Answer: If your provider does not specify that the tension headache is related to some type of psychological factor,  an  appropriate option would be diagnosis code 339.10 (Tension type headache, unspecified) instead of 307.81 (Tension headache). Take note that code 339.10 excludes the following types of headaches, however:

  • Tension headache NOS (307.81)
  • Tension headache related to psychological factors (307.81)
  • Headache NOS (784.0) 
  • Headache due to lumbar puncture (349.0) 
  • Headache migraine (346.0-346.9)

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