Headache Express takes direct referrals for interventional headache management. This section is for referring clinicians and their staff: what we do, what we need from you, and what comes back.
What we treat
Migraine including status migrainosus, cluster headache, occipital neuralgia, cervicogenic headache, tension-type headache, and headache attributed to medication overuse. Procedural work is the reason most referrals come — occipital nerve blocks, sphenopalatine ganglion blocks, superficial trigeminal branch blocks, onabotulinumtoxinA for chronic migraine, and intravenous therapy for an attack that has not broken.
Every injection is placed under ultrasound or fluoroscopy. That is a deliberate standard rather than a selling point: a landmark block that fails is uninterpretable, whereas a guided block that fails has excluded a target.
Who this is useful for
- Primary care — a patient whose acute treatment days are climbing, where the next step is a preventive plan and an assessment of medication overuse rather than another prescription.
- Neurology — where a procedural adjunct is wanted alongside a preventive regimen you are already running, or where a diagnostic block would settle a cervicogenic-versus-migraine question.
- Emergency and urgent care — a patient who has been in twice for the same attack and needs somewhere other than the department to go next.
- Dentistry and oral surgery — facial pain that has not behaved like a dental problem, and temporomandibular contributions to headache.
How to refer
No formal referral form is required and patients may self-refer. If you are sending someone, the useful minimum is the working diagnosis, a count of headache days and acute treatment days per month, what has already been tried and at what dose, and any imaging already done. Send it with the patient or call ahead — details on the contact page.
Please tell the patient to contact us before arriving. Treatment that depends on the right room and the right drug being ready is not compatible with walk-in.
Coding references
- Occipital nerve block coding — greater, lesser and third occipital nerve, bilateral reporting, imaging guidance, and the ICD-10 pairings.
- Headache procedure coding — sphenopalatine, trigeminal, stellate, chemodenervation, facet interventions and infusion codes.
- ICD-10 codes for headache — the migraine, cluster, cervicogenic, neuralgia and medication-overuse families.
A note on jurisdiction
We draw patients from both sides of the river, and the two states sit in different Medicare jurisdictions. Missouri is Jurisdiction 5, administered by Wisconsin Physicians Service Government Health Administrators; Illinois is Jurisdiction 6, administered by National Government Services. Local coverage articles for nerve blocks are not identical between them, which is worth knowing before assuming a policy you have read applies to a patient from the other side.
Reference, not billing advice. Codes change annually, and coverage differs by payer and by Medicare Administrative Contractor. Verify against the current-year CPT code book and your payer’s current policy before submitting. CPT® is a registered trademark of the American Medical Association; descriptions here are abbreviated for identification.