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ICD-10 Guide
ICD-10 CodesG43.10

G43.10

Billable

Migraine with aura, not intractable

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G43.10 is a billable code used to indicate a diagnosis of migraine with aura, not intractable.

Key Diagnostic Point:

Migraine with aura is characterized by recurrent headaches that are often preceded or accompanied by sensory disturbances known as aura. These auras can manifest as visual disturbances (such as flashing lights or blind spots), sensory changes (like tingling or numbness), or speech difficulties. The headaches typically occur on one side of the head and can be moderate to severe in intensity, often exacerbated by physical activity. The not intractable designation indicates that the migraines are manageable and do not meet the criteria for intractable migraines, which are defined by their resistance to treatment and frequency. Patients may experience varying triggers, including stress, hormonal changes, certain foods, and environmental factors. Preventive treatments may include lifestyle modifications, medications such as beta-blockers, anticonvulsants, or antidepressants, and alternative therapies like acupuncture. Accurate diagnosis and coding are essential for effective treatment and management of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between migraine types (with and without aura)
  • Identifying triggers and their documentation
  • Understanding the distinction between intractable and non-intractable migraines
  • Variability in patient presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of aura symptoms
  • Failure to specify the frequency and duration of migraines
  • Misclassification of migraine type
  • Lack of documentation for preventive treatment plans

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed patient history, including frequency and duration of migraines, aura characteristics, and response to treatments.

Common Clinical Scenarios

Patients presenting with recurrent headaches, aura symptoms, and varying triggers.

Billing Considerations

Neurologists must ensure comprehensive documentation of aura symptoms to support the diagnosis.

Primary Care

Documentation Requirements

Thorough documentation of patient-reported symptoms, triggers, and any prescribed preventive measures.

Common Clinical Scenarios

Patients seeking management for migraines with aura, often with comorbid conditions.

Billing Considerations

Primary care providers should document lifestyle factors and patient education on trigger avoidance.

Coding Guidelines

Inclusion Criteria

Use G43.10 When
  • According to ICD
  • 10 guidelines, G43
  • 10 should be used when the patient has a documented history of migraines with aura that are not classified as intractable
  • Documentation must include the presence of aura and its specific characteristics

Exclusion Criteria

Do NOT use G43.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for migraine management.

Documentation Requirements

Document patient history, treatment response, and any changes in symptoms.

Specialty Considerations

Neurologists may require more detailed documentation compared to primary care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of migraine types, improving the accuracy of diagnoses and treatment plans. G43.10 provides a clear distinction between migraines with and without aura, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of migraine types, improving the accuracy of diagnoses and treatment plans. G43.10 provides a clear distinction between migraines with and without aura, facilitating better patient management.

Reimbursement & Billing Impact

reimbursement and quality care.

Resources

Clinical References

  • •
    American Migraine Foundation

Coding & Billing References

  • •
    American Migraine Foundation

Frequently Asked Questions

What distinguishes G43.10 from other migraine codes?

G43.10 specifically refers to migraines with aura that are not intractable, requiring documentation of aura symptoms and their impact on the patient's life.