ICD-10 Coding for Chronic Migraine with Aura(G43.E0, G43.E1)
Complete ICD-10-CM coding and documentation guide for Chronic Migraine with Aura. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Migraine with Aura
G43.E0-G43.E1Primary Range
Chronic migraine with aura, categorized by intractability and status migrainosus
This range includes codes for chronic migraine with aura, specifying intractability and the presence of status migrainosus.
Migraine with aura, not specified as chronic
Used for episodic migraines with aura, differentiating from chronic forms.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G43.E0 | Chronic migraine with aura, not intractable | Use when the patient has chronic migraines with aura that respond to treatment. |
|
| G43.E1 | Chronic migraine with aura, intractable | Use when the patient has chronic migraines with aura that do not respond to treatment. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for chronic migraine with aura
Essential facts and insights about Chronic Migraine with Aura
Primary ICD-10-CM Codes for chronic migraine with aura
Decision Criteria
clinical Criteria
- Headache frequency and aura presence
Applicable To
- Chronic migraine with aura, responsive to treatment
Excludes
- Episodic migraine with aura (G43.1-)
Clinical Validation Requirements
- Headaches occurring ≥15 days/month for ≥3 consecutive months
- Aura symptoms documented (e.g., visual, sensory)
Code-Specific Risks
- Incorrectly coding as intractable without documentation of treatment failure
Coding Notes
- Ensure documentation specifies frequency and response to treatment.
G43.E1 - Chronic migraine with aura, intractable
Use when the patient has chronic migraines with aura that do not respond to treatment.
Applicable To
- Chronic migraine with aura, not responsive to treatment
Excludes
- Episodic migraine with aura (G43.1-)
Clinical Validation Requirements
- Documentation of failed trials of at least two preventive treatments
- Headaches occurring ≥15 days/month for ≥3 consecutive months
Coding Notes
Ensure documentation includes specific failed treatments and their durations.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other long term (current) drug therapy
Z79.899Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Migraine with Aura to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G43.E0.
Impact
Clinical: Inaccurate assessment of intractability., Regulatory: Potential audit issues., Financial: Possible claim denials.
Mitigation Strategy
Ensure detailed treatment history is documented., Use standardized templates for migraine documentation.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Ensure documentation specifies chronicity and use G43.E- codes.
Impact
Failure to document specific treatment failures can lead to audit issues.
Mitigation Strategy
Use detailed templates and ensure all treatment attempts are recorded.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Chronic Migraine with Aura, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Migraine with Aura
Use these documentation templates to ensure complete and accurate documentation for Chronic Migraine with Aura. These templates include all required elements for proper coding and billing.
Chronic migraine with aura, intractable
Specialty: NeurologyRequired Elements
- Headache frequency
- Aura characteristics
- Treatment history and outcomes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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