Migraine Headache ICD 10 Code

Refresher: What are ICD-10 codes?

ICD-10 stands for the International Classification of Diseases. This standardized system classifies medical conditions and helps with diagnoses of various conditions through medical codes. These codes contain information about the following [1]:

• Signs and symptoms of a disease
• Abnormal findings
• Injuries
• Related health problems
• External causes of diseases and injuries, etc.

The US version of these codes was prepared by the National Center for Health Statistics and Medicare & Medicaid Services. These codes belong to two sets/categories:

• CM – Clinical modification
• PCS – Procedure coding system

This tenth edition of the classification system took over the ninth edition when the latter turned out to be outdated. Today, different countries use it in a way that aligns with their healthcare infrastructure.

Medical providers can also receive reimbursement for certain services after submitting ICD-10-CM codes to the payer. When these codes help diagnose a patient’s condition, they also serve as a justification for all the services they get as medically necessary.

What is the ICD 10 code for migraine headaches?

The ICD-10 code for migraine is G43, which comes under the range - Diseases of the nervous system. A migraine can be described as a severe headache with excruciating pain on one side of the head. You may also experience other symptoms such as [2]:

• Mood changes
• Feeling thirsty
• Cravings
• Feeling extreme exhaustion
• Frequent yawning
• Frequent urination
• A stiff neck

You may also experience other symptoms right before getting a migraine. Some of them include:

• Difficulty speaking
• Dizziness
• Sight issues
• A tingling sensation like needles and pins

These symptoms are also called "aura" symptoms, and they shouldn't last for more than an hour.

ICD-10-CM coding is extremely efficient when it comes to differentiating migraines from other common headaches. Researchers are yet to find the cause, but they believe that it is a result of the constriction and dilation of the cephalic blood vessels. Nonetheless, there are also different types of migraines which is why accurate coding is necessary to show what the patient is truly suffering from.

Further specifications are detailed below.

Migraine headache ICD 10 code: G43

Migraine headache ICD 10 code G43 lookup

The table below lists the ICD-10 codes for migraine headaches [3].

G43: Migraine headache

Types of migraine headaches under G43

The ICD 10 code G43 covers different types of migraine headaches, such as:

• Migraine with aura and without aura
• Hemiplegic migraine (migraine with aura and motor weakness)
• Migrainous infarction (ischemic stroke during migraine with aura attack)
• Chronic migraine with aura
• Chronic migraine without aura
• Migraine with cyclical vomiting
• Ophthalmoplegic migraine (mainly affects the eyes and head)
• Abdominal migraine
• Menstrual migraine

Since there are many types of migraine headaches, it’s important to be specific with ICD-10 codes. For example:

• Codes G43.83 and G43.82 suggest that you have menstrual migraine. This is the type of migraine you experience in the days leading up to your period. The term “intractable” suggests that it’s a very severe kind of headache. Hence, we can narrow it down to just G43.83. However, if it lasts longer than 72 hours, it is with “status migrainous.” In this case, the code has to be very specific, G43.831. If the headache does not last longer than 72 hours, the code should be G43.839 [4].
• Code G43.82 also suggests that you have menstrual migraine. But it isn't severe. If it lasts longer than 72 hours, the code should be G43.821 (status migrainous). If it doesn’t last longer than 72 hours, the code should be G43.829 (no status migrainous) [5].
• Similarly, code G43.D suggests that you have abdominal migraine. But, if it isn’t severe or hard to control, the code should be G43.D0. If it is hard to control, it should be G43.D1 [6].

Migraine headache types excluded from ICD-10 G43

Migraine headaches are a part of ICD-10-G43. However, this category does not cover other headache syndromes, such as:

• Chronic cluster headaches
• Episodic and chronic paroxysmal hemicranias
• Post-traumatic headache
• Drug-induced headache
• Headaches associated with sexual activity
• Cervicogenic headache
• Vascular headache
• Tension-type headache

These headaches come under G44 mainly because they don't have the characteristics of migraine [7]. A migraine does not only represent a headache. Furthermore, migraines produce symptoms more severe and intense as compared to other headaches.

For example, a tension headache is not a migraine headache because the pain is only distracting and not debilitating. Migraine headaches, on the other hand, are severe, throbbing headaches.

Similarly, post-traumatic headache is a type of headache that develops a week after head trauma. Another quality that distinguishes migraine headaches from other types of headaches is that their cause is still unknown.

Other headache syndromes have a clear cause. Tension-type headaches are usually a response to anxiety, stress, or depression. Post-traumatic headache is also a reaction to trauma. But it's still unclear as to what causes migraine headaches.

In some cases, the following can trigger migraines [8]:

• Stress
• Depression
• Anxiety
• Skipping meals
• Excessive caffeine consumption
• Lack of exercise

Conclusion

ICD-10 codes for migraine must be assigned after careful evaluation of a patient's symptoms. Most migraines cause debilitating and intense pain, but their symptoms might be very similar to other types of headaches. In many cases, a migraine headache may have the same triggers as other types of headaches, but the pain is much more severe.

And so, differentiating them from other headaches can be challenging. While it broadly falls under ICD-10 G43, migraine has to be further divided into other categories.

It’s also important to note that not all migraine types cause debilitating and severe pain. In some cases, the pain is “intractable,” which means it is hard to control. But in other cases, it is “not intractable,” which means it’s not that hard to control. Hence, relying on the severity of symptoms is not enough to differentiate migraine headaches from other headaches.

It's important to be careful with codes, especially when it comes to diagnosing the right type of migraine headache. Since many types of migraine headaches have similar symptoms, assigning the wrong code can lead to complications, especially when it comes to treating or managing them.

Therefore, it is important for healthcare professionals to clarify the specifics of a patient’s case for accurate reporting and documentation by reading symptoms carefully, identifying causes, understanding complications, and identifying any issues that may be worsening the symptoms.