ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesG43.811

G43.811

Billable

Other migraine, intractable, with status migrainosus

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

Code Description

ICD-10 G43.811 is a billable code used to indicate a diagnosis of other migraine, intractable, with status migrainosus.

Key Diagnostic Point:

G43.811 refers to a specific type of migraine characterized as intractable, meaning it is resistant to treatment and persists for an extended period, often defined as more than 72 hours. Status migrainosus is a severe form of migraine that can lead to debilitating symptoms, including intense headache, nausea, vomiting, and sensitivity to light and sound. Patients may experience a continuous headache that does not respond to typical migraine treatments, necessitating more aggressive management strategies. This condition can significantly impair daily functioning and quality of life, often requiring hospitalization for pain control and supportive care. Triggers for this type of migraine can include stress, hormonal changes, certain foods, and environmental factors. Preventive treatments may involve the use of medications such as beta-blockers, anticonvulsants, or antidepressants, and lifestyle modifications to reduce the frequency and severity of migraine attacks.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between types of migraines
  • Understanding intractability and status migrainosus
  • Identifying appropriate treatment plans
  • Documenting chronicity and severity of symptoms

Audit Risk Factors

  • Inadequate documentation of treatment attempts
  • Failure to specify the duration of symptoms
  • Lack of evidence for intractability
  • Misclassification of migraine type

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed patient history, including frequency and duration of migraines, response to treatments, and any comorbid conditions.

Common Clinical Scenarios

Patients presenting with severe, persistent headaches that have not responded to standard migraine treatments.

Billing Considerations

Neurologists must ensure comprehensive documentation of all treatment modalities attempted and their outcomes.

Primary Care

Documentation Requirements

Thorough documentation of patient symptoms, triggers, and any referrals to specialists.

Common Clinical Scenarios

Patients with recurrent migraines seeking management options and preventive strategies.

Billing Considerations

Primary care providers should document lifestyle factors and patient education on migraine management.

Coding Guidelines

Inclusion Criteria

Use G43.811 When
  • According to ICD
  • 10 guidelines, G43
  • 811 should be used when the migraine is classified as intractable and associated with status migrainosus
  • Coders must ensure that documentation supports the diagnosis and reflects the severity and duration of symptoms

Exclusion Criteria

Do NOT use G43.811 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 patients with chronic migraines.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Neurologists may require more detailed documentation of 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, including intractable migraines. This specificity aids in better understanding and management of the condition, impacting treatment protocols and insurance reimbursements.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of migraine types, including intractable migraines. This specificity aids in better understanding and management of the condition, impacting treatment protocols and insurance reimbursements.

Reimbursement & Billing Impact

reimbursements.

Resources

Clinical References

  • •
    American Migraine Foundation

Coding & Billing References

  • •
    American Migraine Foundation

Frequently Asked Questions

What distinguishes G43.811 from other migraine codes?

G43.811 specifically refers to intractable migraines with status migrainosus, which are resistant to treatment and require detailed documentation of symptoms and treatment history.