A new
term “chronic migraine” has been introduced, Code 1.5.1, and this refers to
migraine headache occurring on 15 or more days per month for more than three
months in the absence of medication overuse.158,159 Another form
of migraine is that which occurs as a consequence of substance withdrawal
including triptans. It is believed that at least 4 to 5 percent of the U.S.
population currently has chronic headaches, many of which are so-called
transformed migraine from the overuse of analgesics. Medication-overuse
headache (MOH) is coded as 8.2. Previously, this was called rebound
headache, drug-induced headache, medication-misuse headache. It is by far
the most common cause of migraine-like headache occurring greater than 15
days per month and of a mixed picture of migraine-like and tension-type-like
headaches from the overuse of symptomatic migraine drugs and/or analgesics.
Roughly, if a patient is using medication 2 to 3 times per week, there is a
tendency to develop medication-overuse headache (MOH).160,161