ICD-10 Coding for Chronic Migraine(G43.E0, G43.E1)
Complete ICD-10-CM coding and documentation guide for Chronic Migraine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Migraine
G43.E0-G43.E1Primary Range
Chronic migraine with and without aura
This range includes codes for chronic migraine conditions, specifying presence or absence of aura.
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 migraine with aura that is not intractable. |
|
| G43.E1 | Chronic migraine with aura, intractable | Use when the patient has chronic migraine with aura that is intractable. |
|
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
Primary ICD-10-CM Codes for chronic migraine
Decision Criteria
clinical Criteria
- Presence of aura and chronic migraine symptoms
Applicable To
- Chronic migraine with aura, not intractable
Excludes
- Chronic tension-type headache (G44.201)
Clinical Validation Requirements
- 15+ headache days per month for 3 months
- Presence of aura symptoms
Code-Specific Risks
- Ensure aura symptoms are documented.
Coding Notes
- Ensure documentation specifies aura presence and chronicity.
G43.E1 - Chronic migraine with aura, intractable
Use when the patient has chronic migraine with aura that is intractable.
Applicable To
- Chronic migraine with aura, intractable
Excludes
- Chronic tension-type headache (G44.201)
Clinical Validation Requirements
- 15+ headache days per month for 3 months
- Presence of aura symptoms
- Failure of two or more preventive treatments
Coding Notes
Ensure documentation specifies aura presence, chronicity, and treatment failures.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Chronic tension-type headache
G44.201Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Migraine 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 diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Denied claims due to insufficient documentation.
Mitigation Strategy
Always document aura symptoms if present.
Impact
Reimbursement: Potential denial due to insufficient specificity., Compliance: Non-compliance with ICD-10 documentation standards., Data Quality: Inaccurate data affecting patient care and research.
Mitigation Strategy
Include specific frequency (15+ days/month) and aura details.
Impact
Failure to document specific headache days/month.
Mitigation Strategy
Use templates to ensure frequency is documented.
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 expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Migraine
Use these documentation templates to ensure complete and accurate documentation for Chronic Migraine. These templates include all required elements for proper coding and billing.
Chronic migraine with aura, intractable
Specialty: NeurologyRequired Elements
- Headache frequency and duration
- Aura symptoms
- Treatment history and response
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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