Migraine ICD-10-CM Codes | 2023
Learn about common migraine ICD-10 codes, their clinical descriptions, billability, and more.
Fact Checked by Ericka Pingol.
What ICD-10 Codes are Used for Migraine?
When it comes to diagnosing and treating migraines, various ICD-10 codes are used to denote the type and nature of the migraine. Here are some commonly used codes:
- G43.001 - Migraine without aura, not intractable, with status migrainosus. This code is used when the patient doesn't experience any warning signs before the onset of the migraine, the migraine isn't resistant to treatment, but the patient experiences a severe, long-lasting migraine attack.
- G43.109 - Migraine with aura, not intractable, without status migrainosus. This code indicates that the patient experiences warning signs before the migraine (like seeing flashing lights), the migraine isn't resistant to treatment, and the patient does not experience a severe, long-lasting migraine attack.
- G43.419 - Chronic migraine without aura, not intractable, without status migrainosus. This code is used when the patient has chronic migraines (headaches on 15 or more days per month for at least three months) without any warning signs. The migraine isn't resistant to treatment without a severe, long-lasting migraine attack.
- G43.701 - Chronic migraine, not intractable, with status migrainosus. This code signifies that the patient suffers from chronic migraines, which aren't resistant to treatment, but the patient experiences severe, long-lasting migraine attacks.
- G43.B0 - Ophthalmoplegic migraine, not intractable, with status migrainosus. This code is used for a rare type of migraine involving paralysis or weakness in muscles controlling eye movement, which isn't resistant to treatment but involves severe, long-lasting migraine attacks.
- G43.C0 - Persistent migraine aura without cerebral infarction. This code denotes instances where the patient experiences persistent visual disturbances typically associated with migraines but without brain tissue death due to lack of blood flow.
For a comprehensive understanding of these Migraine ICD Codes and their application in clinical settings, check out this detailed explainer video.
Remember, staying updated with these codes is critical as they play a significant role in diagnosis, treatment planning, and billing processes.
Which Migraine ICD codes are Billable?
The ICD-10 coding system is used to facilitate billable claims. Here are the commonly used codes for migraines and their billability:
- G43.001 - Migraine without aura, not intractable, with status migrainosus. Billable
- G43.109 - Migraine with aura, not intractable, without status migrainosus. Billable
- G43.419 - Chronic migraine without aura, not intractable, without status migrainosus. Billable
- G43.701 - Chronic migraine, not intractable, with status migrainosus. Billable
- G43.B0 - Ophthalmoplegic migraine, not intractable, with status migrainosus. Billable
- G43.C0 - Persistent migraine aura without cerebral infarction. Billable
These codes are generally billable and can be used for reimbursement. However, verifying with individual insurance providers is crucial as coverage and reimbursement can vary.
Clinical Information
- Migraines are headaches characterized by severe throbbing pain, usually on one side of the head.
- They often come with nausea, vomiting, and extreme sensitivity to light and sound.
- Migraine attacks can cause significant pain for hours to days and can be so severe that the pain is disabling.
- Some individuals may experience auras—sensations that include light flashes or tingling on one side of the face or in an arm or leg—that precede a migraine.
- Not everyone who has migraines will experience an aura. There are two major types of migraines: Migraines without aura (previously known as common migraines) and Migraines with aura (previously known as classic migraines).
- Chronic migraines refer to headaches occurring 15 or more days per month for at least three months.
- An ophthalmoplegic migraine is a rare and severe type accompanied by paralysis in the muscles controlling eye movement.
- Persistent migraine aura without cerebral infarction is when an individual experiences persistent visual disturbances associated with migraines but without any brain tissue death due to lack of blood flow.
- Status migrainosus is a severe and long-lasting migraine that lasts 72 hours or longer. The pain and nausea can be very intense.
- Medications can help prevent some migraines and make them less painful. The right medicines, self-help remedies, and lifestyle changes may help manage migraines.
- Proper coding of migraines using ICD-10 codes is crucial for accurate diagnosis, treatment, and billing.
Synonyms Include
- Severe Headache
- Throbbing Headache
- Migrainous Neurosis
- Hemicrania
- Sick Headache
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Commonly asked questions
You should use a Migraine ICD code when diagnosing a patient with a type of migraine. The specific code you use will depend on the exact type of migraine, its severity, its resistance to treatment, and other factors.
Yes, Migraine diagnoses are typically billable. This means that they can be used for reimbursement purposes. However, coverage and reimbursement specifics can vary among different insurance providers.
Common migraine treatments can include medication (both to prevent attacks and alleviate symptoms during an attack), lifestyle modifications (like managing stress and avoiding triggers), and in some cases, even physical therapy or surgery. The specific treatment will depend on the patient's circumstances and the type of migraine.
A diagnosis code for migraines provides a standardized definition for clinical, research, and billing purposes. It denotes the type of migraine, its severity, whether it's resistant to treatment, and other key aspects of the condition. This allows healthcare professionals to communicate clearly and efficiently about the condition.
