G43 - Migraine
|Status:||Not Valid for Submission|
G43 is a non-specific and non-billable ICD-10 code code, consider using a code with a higher level of specificity for a diagnosis of migraine. The code is not specific and is NOT valid for the year 2023 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.
Specific Coding for Migraine
Non-specific codes like G43 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for migraine:
- NON-BILLABLE CODE - G43.0 for Migraine without aura
- NON-BILLABLE CODE - G43.00 for Migraine without aura, not intractable
- NON-BILLABLE CODE - G43.01 for Migraine without aura, intractable
- NON-BILLABLE CODE - G43.1 for Migraine with aura
- NON-BILLABLE CODE - G43.10 for Migraine with aura, not intractable
- NON-BILLABLE CODE - G43.11 for Migraine with aura, intractable
- NON-BILLABLE CODE - G43.4 for Hemiplegic migraine
- NON-BILLABLE CODE - G43.40 for Hemiplegic migraine, not intractable
- NON-BILLABLE CODE - G43.41 for Hemiplegic migraine, intractable
- NON-BILLABLE CODE - G43.5 for Persistent migraine aura without cerebral infarction
- NON-BILLABLE CODE - G43.50 for Persistent migraine aura without cerebral infarction, not intractable
- NON-BILLABLE CODE - G43.51 for Persistent migraine aura without cerebral infarction, intractable
- NON-BILLABLE CODE - G43.6 for Persistent migraine aura with cerebral infarction
- NON-BILLABLE CODE - G43.60 for Persistent migraine aura with cerebral infarction, not intractable
- NON-BILLABLE CODE - G43.61 for Persistent migraine aura with cerebral infarction, intractable
- NON-BILLABLE CODE - G43.7 for Chronic migraine without aura
- NON-BILLABLE CODE - G43.70 for Chronic migraine without aura, not intractable
- NON-BILLABLE CODE - G43.71 for Chronic migraine without aura, intractable
- NON-BILLABLE CODE - G43.8 for Other migraine
- NON-BILLABLE CODE - G43.80 for Other migraine, not intractable
- NON-BILLABLE CODE - G43.81 for Other migraine, intractable
- NON-BILLABLE CODE - G43.82 for Menstrual migraine, not intractable
- NON-BILLABLE CODE - G43.83 for Menstrual migraine, intractable
- NON-BILLABLE CODE - G43.9 for Migraine, unspecified
- NON-BILLABLE CODE - G43.90 for Migraine, unspecified, not intractable
- NON-BILLABLE CODE - G43.91 for Migraine, unspecified, intractable
- NON-BILLABLE CODE - G43.A for Cyclical vomiting
- BILLABLE CODE - Use G43.A0 for Cyclical vomiting, in migraine, not intractable
- BILLABLE CODE - Use G43.A1 for Cyclical vomiting, in migraine, intractable
- NON-BILLABLE CODE - G43.B for Ophthalmoplegic migraine
- BILLABLE CODE - Use G43.B0 for Ophthalmoplegic migraine, not intractable
- BILLABLE CODE - Use G43.B1 for Ophthalmoplegic migraine, intractable
- NON-BILLABLE CODE - G43.C for Periodic headache syndromes in child or adult
- BILLABLE CODE - Use G43.C0 for Periodic headache syndromes in child or adult, not intractable
- BILLABLE CODE - Use G43.C1 for Periodic headache syndromes in child or adult, intractable
- NON-BILLABLE CODE - G43.D for Abdominal migraine
- BILLABLE CODE - Use G43.D0 for Abdominal migraine, not intractable
- BILLABLE CODE - Use G43.D1 for Abdominal migraine, intractable
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to this diagnosis code:
Use Additional CodeUse Additional Code
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Type 2 ExcludesType 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- headache syndromes G44
- the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled
What are migraines?
Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of your head. You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound.
What causes migraines?
Researchers believe that migraine has a genetic cause. There are also a number of factors that can trigger a migraine. These factors vary from person to person, and they include:
- Hormonal changes in women
- Bright or flashing lights
- Loud noises
- Strong smells
- Too much or not enough sleep
- Sudden changes in weather or environment
- Overexertion (too much physical activity)
- Caffeine or caffeine withdrawal
- Skipped meals
- Medication overuse (taking medicine for migraines too often)
Some people have found that certain foods or ingredients can trigger headaches, especially when they are combined with other triggers. These foods and ingredients include:
- Aged cheeses
- Monosodium glutamate (MSG)
- Some fruits and nuts
- Fermented or pickled goods
- Cured or processed meats
Who is at risk for migraines?
About 12% of Americans get migraines. They can affect anyone, but you are more likely to have them if you:
- Are a woman. Women are three times more likely than men to get migraines.
- Have a family history of migraines. Most people with migraines have family members who have migraines.
- Have other medical conditions, such as depression, anxiety, bipolar disorder, sleep disorders, and epilepsy.
What are the symptoms of migraines?
There are four different phases of migraines. You may not always go through every phase each time you have a migraine.:
- Prodome. This phase starts up to 24 hours before you get the migraine. You have early signs and symptoms, such as food cravings, unexplained mood changes, uncontrollable yawning, fluid retention, and increased urination.
- Aura. If you have this phase, you might see flashing or bright lights or zig-zag lines. You may have muscle weakness or feel like you are being touched or grabbed. An aura can happen just before or during a migraine.
- Headache. A migraine usually starts gradually and then becomes more severe. It typically causes throbbing or pulsing pain, which is often on one side of your head. But sometimes you can have a migraine without a headache. Other migraine symptoms may include
- Increased sensitivity to light, noise, and odors
- Nausea and vomiting
- Worsened pain when you move, cough, or sneeze
- Postdrome (following the headache). You may feel exhausted, weak, and confused after a migraine. This can last up to a day.
Migraines are more common in the morning; people often wake up with them. Some people have migraines at predictable times, such as before menstruation or on weekends following a stressful week of work.
How are migraines diagnosed?
To make a diagnosis, your health care provider will:
- Take your medical history
- Ask about your symptoms
- Do a physical and neurological exam
An important part of diagnosing migraines is to rule out other medical conditions which could be causing the symptoms. So you may also have blood tests, an MRI or CT scan, or other tests.
How are migraines treated?
There is no cure for migraines. Treatment focuses on relieving symptoms and preventing additional attacks.
There are different types of medicines to relieve symptoms. They include triptan drugs, ergotamine drugs, and pain relievers. The sooner you take the medicine, the more effective it is.
There are also other things you can do to feel better:
- Resting with your eyes closed in a quiet, darkened room
- Placing a cool cloth or ice pack on your forehead
- Drinking fluids
There are some lifestyle changes you can make to prevent migraines:
- Stress management strategies, such as exercise, relaxation techniques, and biofeedback, may reduce the number and severity of migraines. Biofeedback uses electronic devices to teach you to control certain body functions, such as your heartbeat, blood pressure, and muscle tension.
- Make a log of what seems to trigger your migraines. You can learn what you need to avoid, such as certain foods and medicines. It also help you figure out what you should do, such as establishing a consistent sleep schedule and eating regular meals.
- Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle
- If you have obesity, losing weight may also be helpful
If you have frequent or severe migraines, you may need to take medicines to prevent further attacks. Talk with your health care provider about which drug would be right for you.
Certain natural treatments, such as riboflavin (vitamin B2) and coenzyme Q10, may help prevent migraines. If your magnesium level is low, you can try taking magnesium. There is also an herb, butterbur, which some people take to prevent migraines. But butterbur may not be safe for long-term use. Always check with your health care provider before taking any supplements.
NIH: National Institute of Neurological Disorders and Stroke
[Learn More in MedlinePlus]
A migraine is a type of headache that typically causes intense, throbbing pain usually in one area of the head. People can experience migraines once a year to multiple times a week. A person is considered to have chronic migraines if they experience 15 or more headache days a month with eight of those days involving migraine headaches. Migraines typically first start during a person's teens to early twenties, but they can begin anytime from early childhood to late-adulthood.
A migraine usually has three stages: the period leading up to the headache (known as the premonitory or prodromal phase), the migraine itself (the headache phase), and the period following the headache (known as the postdromal phase).
The premonitory phase can start from several hours up to several days before the headache appears. In this phase, affected individuals can experience extreme tiredness (fatigue), concentration problems, and muscle stiffness in the neck. A wide variety of additional signs and symptoms can occur including excessive yawning, food cravings, irritability, depression, sensitivity to light, and nausea. About one-third of people with migraine experience a temporary pattern of neurological symptoms called an aura. An aura typically develops gradually over a few minutes and lasts between 5 and 60 minutes. Auras commonly include temporary visual changes such as blind spots (scotomas), flashing lights, and zig-zagging lines of color. Additional features of aura can include numbness, difficulty with speech and language, episodes of extreme dizziness (vertigo), and double vision. During an aura, affected individuals might experience abnormal sensations including tingling or numbness, usually of the hands or mouth. An aura usually starts within one hour of the start of a migraine. In some cases, an aura can occur without a subsequent migraine.
In the headache phase, the pain may last from a few hours to a few days. Affected individuals tend to experience nausea, vomiting, dizziness, and sensitivity to light and sound in addition to headache. Some have changes in their vision or sensitivity to odors and touch.
The postdromal phase usually lasts a few hours but can linger for more than a day. In this phase, the headache pain is gone but individuals can experience fatigue, drowsiness, decreased energy, concentration problems, irritability, nausea, or sensitivity to light. Affected individuals may also have brief episodes of head pain when moving their head.
People with migraine, particularly women who have migraine with aura, have an increased risk of a type of stroke that is caused by a lack of blood flow to the brain (ischemic stroke), but this is a rare occurrence.
There are many migraine disorders that usually include additional signs and symptoms. For example, familial hemiplegic migraine and sporadic hemiplegic migraine are characterized by migraine with associated temporary weakness that affects one side of the body (hemiparesis). Additionally, cyclic vomiting syndrome is a migraine disorder usually found in children that causes episodes of nausea and vomiting in addition to headaches.
[Learn More in MedlinePlus]
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)