ICD-10 Coding for Migraine in Pregnancy(O99.3xx, O26.89x, G43.x)
Complete ICD-10-CM coding and documentation guide for Migraine in Pregnancy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Migraine in Pregnancy
O99.3Primary Range
Mental disorders and diseases of the nervous system complicating pregnancy, childbirth, and the puerperium
Used for pre-existing migraines that are aggravated by pregnancy.
Other specified pregnancy-related conditions
Used for new-onset migraines directly caused by pregnancy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O99.3xx | Mental disorders and diseases of the nervous system complicating pregnancy | Use when a patient has a history of migraines that worsen during pregnancy. |
|
| O26.89x | Other specified pregnancy-related conditions | Use when a patient develops a new migraine during pregnancy. |
|
| G43.x | Migraine | Use to specify the type of migraine in conjunction with pregnancy-related codes. |
|
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 migraine in pregnancy
Essential facts and insights about Migraine in Pregnancy
Primary ICD-10-CM Codes for migraine in pregnancy
Decision Criteria
clinical Criteria
- History of migraine prior to pregnancy
documentation Criteria
- Exacerbation during pregnancy
Applicable To
- Pre-existing migraine aggravated by pregnancy
Excludes
- New-onset migraine due to pregnancy
Clinical Validation Requirements
- History of migraine prior to pregnancy
- Exacerbation during pregnancy
Code-Specific Risks
- Incorrect sequencing if used as secondary when it should be primary
Coding Notes
- Ensure trimester is specified in the code.
O26.89x - Other specified pregnancy-related conditions
Use when a patient develops a new migraine during pregnancy.
Applicable To
- New-onset migraine due to pregnancy
Excludes
- Pre-existing migraine aggravated by pregnancy
Clinical Validation Requirements
- No prior history of migraine
- Onset during pregnancy
Coding Notes
Ensure trimester is specified in the code.
G43.x - Migraine
Use to specify the type of migraine in conjunction with pregnancy-related codes.
Applicable To
- Specific types of migraine such as with aura, without aura
Excludes
- Headaches not classified as migraines
Clinical Validation Requirements
- Documentation of migraine characteristics
Coding Notes
Ensure the specific type of migraine is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Migraine in Pregnancy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O99.3xx.
Impact
Clinical: Inadequate information for treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials due to insufficient documentation.
Mitigation Strategy
Ensure detailed documentation of headache characteristics, Include frequency and associated symptoms
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines for pregnancy complications., Data Quality: Inaccurate representation of the patient's condition in medical records.
Mitigation Strategy
Always pair G43.x with O99.3xx or O26.89x to reflect the pregnancy complication.
Impact
Reimbursement: Incorrect coding can affect DRG and reimbursement., Compliance: Non-compliance with ICD-10 coding requirements., Data Quality: Incomplete data for clinical analysis and reporting.
Mitigation Strategy
Ensure the trimester is included in the code to accurately reflect the stage of pregnancy.
Impact
Using G43.x as primary instead of O99.3xx or O26.89x.
Mitigation Strategy
Train staff on proper code sequencing for pregnancy-related conditions.
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 Migraine in Pregnancy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Migraine in Pregnancy
Use these documentation templates to ensure complete and accurate documentation for Migraine in Pregnancy. These templates include all required elements for proper coding and billing.
Pre-existing migraine exacerbated during pregnancy
Specialty: ObstetricsRequired Elements
- History of migraine
- Exacerbation details
- Trimester
- Migraine characteristics
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Migraine in Pregnancy? Ask your questions below.