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Cluster Headache F070

Document
Last amended 
26 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
20 of 2010
Balance of Probabilities SOP
21 of 2010
Changes from Previous Instruments:

SOP Bulletin 142

ICD Coding:
  • ICD-9-CM Codes: 346.2
  • ICD-10-AM Codes: G44.0

Cluster headaches are a rare and specific form of severe headache.  They occur on one side of the head only, around the eye or temple.  They are of short duration and occur in groups (or clusters).  They occur together with symptoms such as a watering eye, a runny nose and/or sweating.

Is specific diagnostic evidence required to apply the SOP?Yes. 

The diagnosis should be made preferably by a neurologist or specialist physician.  The veteran’s symptoms should be checked against the SOP definition.  If the headaches are not unilateral (one one side only), localised to the eye or temple, and accompanied by eye, nasal or skin symptoms or signs, then the diagnosis of cluster headache should not be confirmed.  Seek medical officer advice if in doubt.

Are there sub-factors that require specific information? – No. 
Additional diagnoses covered by SOP
  • Chronic paroxysmal hemicrania
  • Cluster headache following head trauma
  • Histamine cephalgia
  • Horton’s neuralgia
Conditions not covered by SOP
  • Migraine, ICD code 346.9
  • Headaches due to intracranial structural anomalies - code to anomaly
  • Headaches due to systemic disease - code to underlying disease
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Report from a neurologist