ICD-10 Coding for Complex Migraine(G43.E11, G43.619)
Complete ICD-10-CM coding and documentation guide for Complex Migraine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Complex Migraine
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.E11 | Chronic migraine with aura, intractable, with status migrainosus | For chronic migraines with aura that are intractable and last over 72 hours. |
|
| G43.619 | Persistent migraine aura with cerebral infarction, intractable | When migraine leads to a confirmed cerebral infarction. |
|
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 complex migraine
Essential facts and insights about Complex Migraine
Primary ICD-10-CM Codes for complex migraine
Decision Criteria
clinical Criteria
- Presence of aura and chronicity
documentation Criteria
- Detailed headache diary and treatment history
Applicable To
- Chronic migraine with aura
- Intractable migraine
Excludes
- Episodic migraine
- Non-migraine headaches
Clinical Validation Requirements
- Documented 15+ headache days/month for 3+ months
- Presence of aura symptoms
- Failure of 3+ treatment modalities
Code-Specific Risks
- Misclassification if aura is not documented
- Incorrect use if chronicity criteria are not met
Coding Notes
- Ensure documentation specifies aura type and treatment failures.
G43.619 - Persistent migraine aura with cerebral infarction, intractable
When migraine leads to a confirmed cerebral infarction.
Applicable To
- Migraine-induced stroke
Excludes
- Non-ischemic aura
Clinical Validation Requirements
- MRI/CT confirmation of cerebral infarction
- Neurologist confirmation
Coding Notes
Always sequence cerebral infarction first.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Complex Migraine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G43.E11.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure aura details are documented, Use standardized templates
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of health data.
Mitigation Strategy
Ensure detailed documentation to support specific code selection.
Impact
Lack of detailed aura documentation can lead to audit issues.
Mitigation Strategy
Use templates to ensure complete documentation.
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 Complex Migraine, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Complex Migraine
Use these documentation templates to ensure complete and accurate documentation for Complex Migraine. These templates include all required elements for proper coding and billing.
Chronic migraine with aura and intractability
Specialty: NeurologyRequired Elements
- Headache frequency
- Aura type and duration
- Treatment failures
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Complex Migraine? Ask your questions below.