Hemiplegic migraine, intractable, without status migrainosus
ICD-10 G43.419 is a billable code used to indicate a diagnosis of hemiplegic migraine, intractable, without status migrainosus.
Hemiplegic migraine is a rare and severe form of migraine characterized by temporary paralysis or weakness on one side of the body, known as hemiplegia. This condition can be intractable, meaning it does not respond to standard migraine treatments and can significantly impair a patient's quality of life. Patients may experience aura symptoms, including visual disturbances, sensory changes, and speech difficulties, prior to the onset of headache. The intractable nature of this migraine type often leads to prolonged episodes of headache that can last for days or weeks. Unlike status migrainosus, which is defined by a continuous migraine lasting more than 72 hours, hemiplegic migraine can occur episodically but is marked by its severe neurological symptoms. Triggers for hemiplegic migraines can include stress, hormonal changes, certain foods, and environmental factors. Preventive treatments may involve medications such as beta-blockers, anticonvulsants, or calcium channel blockers, tailored to the individual patient's needs.
Detailed neurological examination findings, history of migraine episodes, and treatment responses.
Patients presenting with hemiplegic symptoms during migraine attacks, requiring differential diagnosis from stroke.
Neurologists must document the severity and frequency of episodes to justify the intractable designation.
Comprehensive pain assessments and treatment plans, including medication trials and responses.
Management of chronic migraine patients who have not responded to standard therapies.
Pain management specialists should document all interventions and their outcomes to support coding.
Used for follow-up visits for chronic migraine management.
Document history of present illness, review of systems, and treatment plan.
Neurologists should ensure detailed neurological assessments are included.
Hemiplegic migraine is characterized by temporary paralysis or weakness on one side of the body, which is not typical of other migraine types. It also has a genetic component and can be intractable, requiring specialized management.
