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v1.0.0
ICD-10 Guide
ICD-10 CodesG43.701

G43.701

Billable

Chronic migraine without aura, not intractable, with status migrainosus

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

Code Description

ICD-10 G43.701 is a billable code used to indicate a diagnosis of chronic migraine without aura, not intractable, with status migrainosus.

Key Diagnostic Point:

Chronic migraine without aura, not intractable, with status migrainosus is characterized by the occurrence of migraine headaches on 15 or more days per month, with at least 8 of those days meeting the criteria for migraine. This condition is distinguished from other types of migraines by the absence of aura, which are sensory disturbances that can precede a migraine attack. Status migrainosus refers to a severe migraine attack that lasts longer than 72 hours, leading to significant impairment in daily functioning. Patients may experience debilitating pain, nausea, vomiting, and sensitivity to light and sound. Chronic migraines can be triggered by various factors, including stress, hormonal changes, certain foods, and environmental stimuli. Preventive treatments may include medications such as beta-blockers, anticonvulsants, and antidepressants, as well as lifestyle modifications to reduce triggers. Accurate diagnosis and management are crucial to improve the quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between chronic and episodic migraines
  • Identifying the presence of status migrainosus
  • Understanding the absence of aura in chronic migraines
  • Documenting frequency and severity of headaches

Audit Risk Factors

  • Inadequate documentation of headache frequency and duration
  • Failure to specify the absence of aura
  • Lack of evidence for status migrainosus
  • Misclassification of migraine type

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed headache diaries, treatment response, and comorbid conditions.

Common Clinical Scenarios

Patients presenting with frequent headaches, medication overuse, or those requiring preventive therapy.

Billing Considerations

Neurologists must ensure comprehensive documentation of headache characteristics and treatment plans.

Primary Care

Documentation Requirements

History of headache patterns, triggers, and response to treatments.

Common Clinical Scenarios

Patients with recurrent headaches seeking management options or referrals to specialists.

Billing Considerations

Primary care providers should document lifestyle factors and potential triggers to aid in management.

Coding Guidelines

Inclusion Criteria

Use G43.701 When
  • According to ICD
  • 10 guidelines, chronic migraines must be documented with specific details regarding frequency, duration, and associated symptoms
  • Status migrainosus must be clearly indicated to justify the use of G43

Exclusion Criteria

Do NOT use G43.701 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits for chronic migraine management.

Documentation Requirements

Document history of present illness, review of systems, and treatment plan.

Specialty Considerations

Neurologists may require more detailed neurological examinations.

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. G43.701 provides a clear distinction for chronic migraines with status migrainosus, enhancing clinical understanding and 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. G43.701 provides a clear distinction for chronic migraines with status migrainosus, enhancing clinical understanding and management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of migraine types, improving the accuracy of diagnoses and treatment plans. G43.701 provides a clear distinction for chronic migraines with status migrainosus, enhancing clinical understanding and management.

Resources

Clinical References

  • •
    American Migraine Foundation

Coding & Billing References

  • •
    American Migraine Foundation

Frequently Asked Questions

What distinguishes chronic migraine from episodic migraine?

Chronic migraine is defined by the occurrence of headaches on 15 or more days per month, while episodic migraine occurs less frequently.