ICHD-II

Subjective Complaint Key: 0 = Pain Free, 5 = Moderate, 10 = Sever Pain. Headache Occipital Frontal Temporal . L R L R L R Neck Pain Stiffness Paresthesia Spasm L R L R L R L R Upper Pain Stiffness Paresthesia Spasm Back L R L R L R L R Midback Pain Stiffness Paresthesia Spasm ... ICD-9 CPT E/M Date: / / Visit of Subjective. ................
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