G43 — Migraine

Excludes1 — never code together

The conditions below can never be reported together with G43 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

• lower half migraine (G44.00)

Use additional code

Report an additional code alongside G43 to fully describe the condition. G43 is sequenced first.

• code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Excludes2 — not included here

The conditions below are not part of G43, but a patient may have both at the same time. When documentation supports it, G43 and the excluded code may both be reported.

• headache NOS (R51.9)
• headache syndromes (G44.-)

Note

• the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled

Excludes2 — not included here — inherited from Chapter 6

The conditions below are not part of G43, but a patient may have both at the same time. When documentation supports it, G43 and the excluded code may both be reported.

• certain conditions originating in the perinatal period (P04-P96)
• certain infectious and parasitic diseases (A00-B99)
• complications of pregnancy, childbirth and the puerperium (O00-O9A)
• congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
• endocrine, nutritional and metabolic diseases (E00-E88)
• injury, poisoning and certain other consequences of external causes (S00-T88)
• neoplasms (C00-D49)
• symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)