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ICD-10 Coding for Postpartum Migraine(G43.909, G43.109)

Complete ICD-10-CM coding and documentation guide for Postpartum Migraine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Postnatal MigraineMigraine after childbirth

Related ICD-10 Code Ranges

Complete code families applicable to Postpartum Migraine

G43Primary Range

Migraine

Primary range for coding migraines, including postpartum migraines.

Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

Used to indicate the postpartum context of the migraine.

Encounter for maternal postpartum care

Used to indicate routine postpartum follow-up care.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
G43.909Migraine, unspecified, not intractableUse for postpartum migraines without aura.
  • Documented frequency of headaches
  • Temporal relationship to postpartum period
  • Response to treatment
G43.109Migraine with aura, not intractableUse for postpartum migraines with aura.
  • Presence of aura symptoms
  • Temporal relationship to postpartum period
  • Response 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 postpartum migraine

Essential facts and insights about Postpartum Migraine

The ICD-10 code for postpartum migraine without aura is G43.909. For migraines with aura, use G43.109. Pair with O99.89 for postpartum context.

Primary ICD-10-CM Codes for postpartum migraine

Migraine, unspecified, not intractable
Billable Code

Decision Criteria

clinical Criteria

  • Headache frequency and postpartum onset

documentation Criteria

  • Detailed headache characteristics and treatment response

Applicable To

  • Postpartum migraine without aura

Excludes

Clinical Validation Requirements

  • Documented frequency of headaches
  • Temporal relationship to postpartum period
  • Response to treatment

Code-Specific Risks

  • Misclassification as tension-type headache

Coding Notes

  • Ensure documentation specifies postpartum onset and frequency.

Ancillary Codes

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

Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium

O99.89
Use to indicate the postpartum context of the migraine.

Encounter for routine postpartum follow-up

Z39.2
Use to indicate postpartum care context.

Differential Codes

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

Tension-type headache, unspecified, not intractable

G44.209
Lacks migraine-specific symptoms like aura or photophobia.

Cluster headache syndrome, unspecified, not intractable

G44.009
Cluster headaches have different timing and symptomatology.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Postpartum Migraine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G43.909.

Impact

Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.

Mitigation Strategy

Use specific migraine terminology., Include detailed symptom descriptions.

Impact

Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on migraine prevalence.

Mitigation Strategy

Ensure migraines are coded with G43.x codes and linked to postpartum status.

Impact

Inadequate documentation of headache frequency can lead to audit issues.

Mitigation Strategy

Ensure consistent documentation of 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 Postpartum Migraine, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Postpartum Migraine

Use these documentation templates to ensure complete and accurate documentation for Postpartum Migraine. These templates include all required elements for proper coding and billing.

Neurology Progress Note for Postpartum Migraine

Specialty: Neurology

Required Elements

  • Headache frequency
  • Postpartum onset
  • Treatment response
  • Aura presence

Example Documentation

**HPI:** 32yo F 4 weeks postpartum c/o throbbing R temporal headache x 8/10 intensity, 16 days/month, photophobia, nausea. No aura. Failed naproxen 500mg BID. **Exam:** Normal neuro, no meningismus. **Assessment:** G43.909 (Postpartum migraine, not intractable); O99.89; Z39.2 **Plan:** Start erenumab 140mg SC monthly; avoid NSAIDs while breastfeeding.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Postpartum headaches
Good Documentation Example
Migraine with photophobia, 18 headache days/month, onset 2 weeks postpartum unresponsive to acetaminophen
Explanation
The good example specifies the migraine characteristics, frequency, and treatment response.

Need help with ICD-10 coding for Postpartum Migraine? Ask your questions below.

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

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