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v1.0.0
ICD-10 Guide
ICD-10 CodesG43.611

G43.611

Billable

Persistent migraine aura with cerebral infarction, intractable, with status migrainosus

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

Code Description

ICD-10 G43.611 is a billable code used to indicate a diagnosis of persistent migraine aura with cerebral infarction, intractable, with status migrainosus.

Key Diagnostic Point:

G43.611 refers to a severe and complex form of migraine characterized by persistent aura symptoms that last longer than the typical duration, often accompanied by cerebral infarction. This condition is classified as intractable, indicating that it does not respond to standard treatments and can lead to significant disability. Patients may experience prolonged visual disturbances, sensory changes, and other neurological symptoms that can mimic stroke. The presence of status migrainosus indicates that the migraine attacks are continuous and debilitating, lasting longer than 72 hours. This condition requires careful management and may necessitate hospitalization for acute treatment and preventive strategies. The interplay between migraine and cerebral infarction highlights the importance of timely diagnosis and intervention to prevent further neurological damage.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires differentiation from other types of migraines and headaches.
  • Involves understanding of both migraine and stroke pathology.
  • Documentation must clearly indicate the intractable nature of the condition.
  • Need for comprehensive patient history and symptom tracking.

Audit Risk Factors

  • Inadequate documentation of symptoms and duration.
  • Failure to specify the intractable nature of the migraine.
  • Misclassification of migraine type.
  • Lack of evidence for cerebral infarction.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and treatment history.

Common Clinical Scenarios

Patients presenting with prolonged aura symptoms and neurological deficits.

Billing Considerations

Ensure clear documentation of the relationship between migraine symptoms and any infarction.

Emergency Medicine

Documentation Requirements

Acute treatment records, imaging studies, and patient history.

Common Clinical Scenarios

Patients presenting to the ER with severe headache and neurological symptoms.

Billing Considerations

Rapid assessment and documentation of symptoms to rule out other conditions.

Coding Guidelines

Inclusion Criteria

Use G43.611 When
  • Follow ICD
  • CM guidelines for coding migraines, ensuring accurate documentation of symptoms, duration, and any associated conditions
  • Include details about the intractable nature and status migrainosus

Exclusion Criteria

Do NOT use G43.611 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99223CPT Code

Initial hospital care, high complexity

Clinical Scenario

Used for patients admitted with severe migraines and neurological symptoms.

Documentation Requirements

Detailed history, examination findings, and treatment plan.

Specialty Considerations

Neurologists should document the neurological assessment thoroughly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of complex migraine conditions, improving the accuracy of diagnoses and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of complex migraine conditions, improving the accuracy of diagnoses and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of complex migraine conditions, improving the accuracy of diagnoses and treatment tracking.

Resources

Clinical References

  • •
    American Migraine Foundation

Coding & Billing References

  • •
    American Migraine Foundation

Frequently Asked Questions

What are the key symptoms of G43.611?

Key symptoms include persistent aura lasting more than an hour, severe headache, and neurological deficits indicative of cerebral infarction.