Back to HomeBeta

ICD-10 Coding for Chronic Migraine Without Aura(G43.701, G43.709, G43.719, G43.729)

Complete ICD-10-CM coding and documentation guide for Chronic Migraine Without Aura. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Chronic MigraineMigraine Without Aura

Quick Navigation

Related ICD-10 Code Ranges

Complete code families applicable to Chronic Migraine Without Aura

G43.7Primary Range

Chronic migraine without aura

This range includes all codes for chronic migraine without aura, specifying intractability and status migrainosus.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
G43.701Chronic migraine without aura, not intractable, with status migrainosusUse when the patient experiences chronic migraine without aura, not intractable, with status migrainosus.
  • Headache unresponsive to IV dihydroergotamine for 84+ hours
  • ≥15 headache days/month for 3 months
G43.709Chronic migraine without aura, not intractable, without status migrainosusUse when the patient experiences chronic migraine without aura, not intractable, without status migrainosus.
  • 15+ headache days/month for 4 months
  • Responds to sumatriptan
G43.719Chronic migraine without aura, intractable, without status migrainosusUse when the patient experiences chronic migraine without aura, intractable, without status migrainosus.
  • Failed 3+ preventive therapies (topiramate, propranolol, CGRP mAb)
  • ER visit 2x/month
G43.729Chronic migraine without aura, intractable, with status migrainosusUse when the patient experiences chronic migraine without aura, intractable, with status migrainosus.
  • 72-hour refractory headache
  • Failed IV valproate/steroids

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 without aura

Essential facts and insights about Chronic Migraine Without Aura

The ICD-10 code for chronic migraine without aura is G43.7, with specific codes for intractability and status migrainosus.

Primary ICD-10-CM Codes for chronic migraine without aura

G43.701
Chronic migraine without aura, not intractable, with status migrainosus
Billable Code

Decision Criteria

clinical Criteria

  • Patient has ≥15 headache days/month for 3 months.

documentation Criteria

  • Status migrainosus documented as lasting more than 72 hours.

Applicable To

  • Chronic migraine without aura with prolonged migraine attack

Excludes

  • Chronic migraine with aura (G43.E-)

Clinical Validation Requirements

  • Headache unresponsive to IV dihydroergotamine for 84+ hours
  • ≥15 headache days/month for 3 months

Code-Specific Risks

  • Ensure status migrainosus is documented as lasting more than 72 hours.

Coding Notes

  • Ensure documentation specifies the absence of aura and the presence of status migrainosus.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Personal history of other diseases of the nervous system

Z86.603
Use if there is a history of migraines but no current active condition.

Cervicalgia

M54.2
Use if neck pain is a component of the headache.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Tension-type headache

G44.0
Tension-type headaches are bilateral and non-pulsating, unlike migraines.

Vascular headache, not elsewhere classified

G44.1
Vascular headaches are not classified as migraines and have different treatment protocols.

Tension-type headache, chronic

G44.2
Chronic tension-type headaches are not pulsating and lack migraine features.

Cluster headache syndrome

G44.3
Cluster headaches are shorter and occur in clusters, unlike migraines.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Chronic Migraine Without Aura to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G43.701.

Impact

Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential claim denials due to incomplete documentation.

Mitigation Strategy

Always specify presence or absence of aura in documentation., Use templates to ensure completeness.

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 documentation standards., Data Quality: Inaccurate patient records and treatment plans.

Mitigation Strategy

Ensure documentation specifies ≥15 headache days/month for 3 months.

Impact

Reimbursement: May affect DRG assignment and reimbursement rates., Compliance: Potential audit issues due to incorrect coding., Data Quality: Misleading data on treatment efficacy.

Mitigation Strategy

Verify documentation of failed therapies to confirm intractability.

Impact

Lack of specific frequency documentation can trigger audits.

Mitigation Strategy

Ensure all records specify headache days per month.

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 Without Aura, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Chronic Migraine Without Aura

Use these documentation templates to ensure complete and accurate documentation for Chronic Migraine Without Aura. These templates include all required elements for proper coding and billing.

Chronic migraine without aura, intractable

Specialty: Neurology

Required Elements

  • Frequency of headaches
  • Treatment history and outcomes
  • Intractability status
  • Presence or absence of aura

Example Documentation

Patient presents with 18 headache days/month for 6 months. Failed topiramate and propranolol. No aura symptoms. Plan: Start erenumab.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has chronic migraines.
Good Documentation Example
Patient has chronic migraines with 18 headache days/month for 6 months, failed topiramate and propranolol.
Explanation
The good example provides specific frequency and treatment history, meeting documentation requirements.

Need help with ICD-10 coding for Chronic Migraine Without Aura? Ask your questions below.

Ask about any ICD-10 CM code, or paste a medical note

We build tools for
clinician happiness.

Learn More at Freed.ai
Back to HomeBeta

Built by Freed

Try Freed for free for 7 days.

Learn more

Helpful Links

How ICD 10 AI Lookup WorksContact UsPrivacy Policy