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v1.0.0
ICD-10 Guide
ICD-10 CodesG43.80

G43.80

Billable

Other migraine, not intractable

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

Code Description

ICD-10 G43.80 is a billable code used to indicate a diagnosis of other migraine, not intractable.

Key Diagnostic Point:

G43.80 refers to a category of migraine disorders that do not fall under the more specific classifications of migraine with aura or migraine without aura. This code is used for patients experiencing migraine episodes that are not classified as intractable, meaning they are manageable and do not require emergency interventions. Patients may experience varying symptoms, including unilateral or bilateral throbbing pain, nausea, vomiting, and sensitivity to light and sound. Triggers for these migraines can include stress, hormonal changes, certain foods, and environmental factors. The condition can significantly impact daily functioning and quality of life, necessitating effective management strategies. Treatment options may include abortive therapies, such as triptans, and preventive measures, including lifestyle modifications and prophylactic medications. Accurate coding is essential for appropriate treatment planning and insurance reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of migraine types and triggers complicating diagnosis
  • Need for thorough patient history to identify non-intractable status
  • Potential overlap with other headache disorders
  • Documentation of treatment response and preventive measures

Audit Risk Factors

  • Inadequate documentation of migraine triggers
  • Failure to specify the non-intractable nature of the migraine
  • Lack of evidence for preventive treatment plans
  • Misclassification of migraine types

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed patient history, including migraine frequency, duration, and triggers; treatment response; and any comorbid conditions.

Common Clinical Scenarios

Patients presenting with recurrent headaches, varying in intensity and duration, requiring differentiation from other headache types.

Billing Considerations

Neurologists must ensure comprehensive documentation to support the diagnosis and treatment plan, especially when considering preventive therapies.

Primary Care

Documentation Requirements

Documentation of patient-reported symptoms, lifestyle factors, and any prescribed treatments or referrals to specialists.

Common Clinical Scenarios

Patients with episodic migraines seeking management strategies or referrals to specialists for persistent symptoms.

Billing Considerations

Primary care providers should be aware of the need for thorough documentation to support the diagnosis and any referrals made.

Coding Guidelines

Inclusion Criteria

Use G43.80 When
  • According to the ICD
  • 10 coding guidelines, G43
  • 80 should be used when the migraine is not classified as intractable
  • Coders must ensure that the documentation supports the diagnosis and that the migraine is not due to another underlying condition

Exclusion Criteria

Do NOT use G43.80 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 the patient's history, current symptoms, and treatment plan.

Specialty Considerations

Neurologists may require more detailed documentation compared to primary care providers.

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. G43.80 provides a clear classification for non-intractable migraines, 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. G43.80 provides a clear classification for non-intractable migraines, facilitating better patient 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. G43.80 provides a clear classification for non-intractable migraines, facilitating better patient management.

Resources

Clinical References

  • •
    American Migraine Foundation

Coding & Billing References

  • •
    American Migraine Foundation

Frequently Asked Questions

What distinguishes G43.80 from other migraine codes?

G43.80 is specifically for migraines that are not classified as intractable, allowing for broader categorization of migraine types and management strategies.