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v1.0.0
ICD-10 Guide
ICD-10 CodesG43.501

G43.501

Billable

Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus

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

Code Description

ICD-10 G43.501 is a billable code used to indicate a diagnosis of persistent migraine aura without cerebral infarction, not intractable, with status migrainosus.

Key Diagnostic Point:

Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus refers to a condition characterized by prolonged visual or sensory disturbances that occur alongside migraine headaches. This condition is distinct from typical migraines as it involves persistent aura symptoms lasting more than one week, without evidence of cerebral infarction. Patients may experience visual disturbances such as flashing lights, zigzag patterns, or sensory symptoms like numbness or tingling. The term 'status migrainosus' indicates that the patient is experiencing a migraine attack that lasts longer than 72 hours, which can lead to significant disability. This condition requires careful management to alleviate symptoms and prevent further attacks. Triggers for these migraines can include stress, hormonal changes, certain foods, and environmental factors. Preventive treatments may involve medications such as beta-blockers, anticonvulsants, or CGRP inhibitors, alongside lifestyle modifications to reduce the frequency and severity of migraine episodes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other migraine types
  • Need for detailed documentation of aura symptoms
  • Understanding of status migrainosus criteria
  • Management of co-existing conditions

Audit Risk Factors

  • Inadequate documentation of aura symptoms
  • Failure to specify the duration of symptoms
  • Misclassification of migraine types
  • Lack of evidence for status migrainosus

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed patient history, including frequency and duration of migraines, aura symptoms, and response to treatments.

Common Clinical Scenarios

Patients presenting with prolonged aura symptoms, recurrent migraines, and those requiring preventive therapy.

Billing Considerations

Neurologists must ensure accurate documentation of aura characteristics and treatment plans to support coding.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings, including triggers and lifestyle factors.

Common Clinical Scenarios

Patients with recurrent headaches, those seeking preventive treatment, and referrals to specialists.

Billing Considerations

Primary care providers should document all relevant symptoms and treatment responses to facilitate accurate coding.

Coding Guidelines

Inclusion Criteria

Use G43.501 When
  • According to ICD
  • 10 guidelines, G43
  • 501 should be used when the patient has persistent aura symptoms without cerebral infarction and is not classified as intractable
  • Documentation must clearly indicate the duration of aura and the presence of status migrainosus

Exclusion Criteria

Do NOT use G43.501 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 migraine management.

Documentation Requirements

Document the patient's history, examination findings, 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. G43.501 provides a clear distinction for persistent aura cases, which aids in better patient management and resource allocation.

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. G43.501 provides a clear distinction for persistent aura cases, which aids in better patient management and resource allocation.

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. G43.501 provides a clear distinction for persistent aura cases, which aids in better patient management and resource allocation.

Resources

Clinical References

  • •
    American Migraine Foundation

Coding & Billing References

  • •
    American Migraine Foundation

Frequently Asked Questions

What distinguishes G43.501 from other migraine codes?

G43.501 specifically refers to persistent migraine aura without cerebral infarction and includes the criteria for status migrainosus, which requires detailed documentation of symptoms and duration.