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v1.0.0
ICD-10 Guide
ICD-10 CodesG43.8

G43.8

Billable

Other migraine

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

Code Description

ICD-10 G43.8 is a billable code used to indicate a diagnosis of other migraine.

Key Diagnostic Point:

G43.8 refers to 'Other migraine,' which encompasses various types of migraine disorders that do not fit into the more commonly recognized categories such as migraine without aura (G43.0) or migraine with aura (G43.1). This code is used for atypical migraine presentations, including but not limited to hemiplegic migraine, retinal migraine, and chronic migraine. Patients may experience a range of symptoms, including unilateral throbbing headache, nausea, vomiting, photophobia, and phonophobia. Triggers for these migraines can vary widely and may include stress, hormonal changes, certain foods, and environmental factors. Preventive treatments may involve lifestyle modifications, pharmacological interventions such as beta-blockers, anticonvulsants, or antidepressants, and alternative therapies like acupuncture or biofeedback. Accurate coding for G43.8 requires a thorough understanding of the patient's migraine history and the specific characteristics of their migraine episodes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of migraine types included under this code
  • Need for detailed patient history to determine specific migraine type
  • Potential overlap with other headache disorders
  • Variability in treatment approaches and preventive measures

Audit Risk Factors

  • Inadequate documentation of migraine type and symptoms
  • Failure to document triggers and preventive measures
  • Misclassification of migraine types leading to incorrect coding
  • Lack of follow-up documentation for chronic migraine management

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed patient history, including migraine frequency, duration, and associated symptoms.

Common Clinical Scenarios

Patients presenting with recurrent headaches that do not fit typical migraine classifications.

Billing Considerations

Neurologists should document any neurological deficits or atypical symptoms to support the use of G43.8.

Primary Care

Documentation Requirements

Comprehensive documentation of patient-reported symptoms and any attempted treatments.

Common Clinical Scenarios

Patients with chronic headaches seeking management options.

Billing Considerations

Primary care providers should ensure thorough documentation of lifestyle factors and triggers.

Coding Guidelines

Inclusion Criteria

Use G43.8 When
  • According to the official coding guidelines, G43
  • 8 should be used when the migraine type is not specified elsewhere in the classification
  • Coders should ensure that the documentation supports the use of this code and that it is not used when a more specific migraine code is applicable

Exclusion Criteria

Do NOT use G43.8 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

Documentation of patient history, treatment response, and any changes in symptoms.

Specialty Considerations

Neurologists may require more detailed neurological assessments.

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 ability to track and manage migraine disorders. G43.8 provides a necessary code for atypical presentations that may have been previously underrepresented in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of migraine types, improving the ability to track and manage migraine disorders. G43.8 provides a necessary code for atypical presentations that may have been previously underrepresented in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of migraine types, improving the ability to track and manage migraine disorders. G43.8 provides a necessary code for atypical presentations that may have been previously underrepresented in ICD-9.

Resources

Clinical References

  • •
    International Classification of Headache Disorders

Coding & Billing References

  • •
    International Classification of Headache Disorders

Frequently Asked Questions

What types of migraines are included under G43.8?

G43.8 includes various atypical migraine presentations such as hemiplegic migraine, retinal migraine, and chronic migraine that do not fit into the more common categories.

How can I ensure accurate coding for G43.8?

Accurate coding requires thorough documentation of the patient's migraine history, including specific symptoms, triggers, and any treatments attempted.