2026 ICD-10-CM Diagnosis Code G43.C1Periodic headache syndromes in child or adult, intractable
ICD-10-CM Codes›G00–G99›G40-G47›G43
- Billable — Valid for Submission
- Chronic Condition
G43.C1 is a billable ICD-10-CM diagnosis code for periodic headache syndromes in child or adult, intractable. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 102 through 103. Coders also document this condition as episodic migraine. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Headache; including migraine.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Episodic migraine
- Intermittent headache
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Periodic headache syndromes in child or adult, with refractory migraine
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- periodic syndromes in adults and children - G43.C0
- with refractory migraine - G43.C1
- intractable - G43.C1
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Headache
- periodic syndromes in adults and children
- with refractory migraine
- Headache
- periodic syndromes in adults and children
- intractable
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
Convert G43.C1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About G43.C1Overview
Is G43.C1 (Periodic headache syndromes in child or adult) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report periodic headache syndromes in child or adult, intractable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does G43.C1 group to?
When periodic headache syndromes in child or adult, intractable is the principal diagnosis on an inpatient stay, it groups to MS-DRG 102, 103, with relative weights from 0.8363 to 1.1209 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of G43.C1?
Under the General Equivalence Mappings, periodic headache syndromes in child or adult, intractable converts to ICD-9-CM 346.21 (vrnt mgrn w ntrc mgr NEC). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:
- The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
- The condition places limitations on self-care, independent living, and social interactions.
