G43 is a non-billable ICD-10-CM category code for migraine, so it cannot be submitted on claims. Use a more specific code from this category instead, such as G43.001, G43.009, G43.011, and G43.019.
Code Identity
Code Classification
Specific Coding for MigraineOverview
Non-specific codes like G43 require more characters. Use one of these billable codes instead:
G43.0 for Migraine without aura
G43.00 for Migraine without aura, not intractable
G43.01 for Migraine without aura, intractable
G43.1 for Migraine with aura
G43.10 for Migraine with aura, not intractable
G43.11 for Migraine with aura, intractable
G43.4 for Hemiplegic migraine
G43.40 for Hemiplegic migraine, not intractable
G43.41 for Hemiplegic migraine, intractable
G43.5 for Persistent migraine aura without cerebral infarction
G43.50 for Persistent migraine aura without cerebral infarction, not intractable
G43.51 for Persistent migraine aura without cerebral infarction, intractable
G43.6 for Persistent migraine aura with cerebral infarction
G43.60 for Persistent migraine aura with cerebral infarction, not intractable
G43.61 for Persistent migraine aura with cerebral infarction, intractable
G43.7 for Chronic migraine without aura
G43.70 for Chronic migraine without aura, not intractable
G43.71 for Chronic migraine without aura, intractable
G43.8 for Other migraine
G43.80 for Other migraine, not intractable
G43.81 for Other migraine, intractable
G43.82 for Menstrual migraine, not intractable
G43.83 for Menstrual migraine, intractable
G43.9 for Migraine, unspecified
G43.90 for Migraine, unspecified, not intractable
G43.91 for Migraine, unspecified, intractable
G43.A for Cyclical vomiting
Use G43.A0 for Cyclical vomiting, in migraine, not intractable
Use G43.A1 for Cyclical vomiting, in migraine, intractable
G43.B for Ophthalmoplegic migraine
Use G43.B0 for Ophthalmoplegic migraine, not intractable
Use G43.B1 for Ophthalmoplegic migraine, intractable
G43.C for Periodic headache syndromes in child or adult
Use G43.C0 for Periodic headache syndromes in child or adult, not intractable
Use G43.C1 for Periodic headache syndromes in child or adult, intractable
G43.D for Abdominal migraine
Use G43.D0 for Abdominal migraine, not intractable
Use G43.D1 for Abdominal migraine, intractable
G43.E for Chronic migraine with aura
G43.E0 for Chronic migraine with aura, not intractable
G43.E1 for Chronic migraine with aura, intractable
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Use Additional Code
Type 1 Excludes
Type 2 Excludes
- headache syndromes G44
- the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled
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.
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.
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.
Patient EducationClinical
Migraine
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.
The full article covers:
- What are migraines?
- What causes migraines?
- Who is at risk for migraines?
- What are the symptoms of migraines?
- How are migraines diagnosed?
- How are migraines treated?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
